The Food poisoning outbreak caused by diarrhoeal Bacillus Cereus in Tegalkenongo Village, Bantul, Yogyakarta, Indonesia: a retrospective study

Purpose: This study aimed to investigate the causative agents, source of food poisoning, and mode of food poisoning transmission in Tegalkenongo Village. Method: A retrospective cohort study was used in the epidemiological investigation for one week from 13 May 2019 – 20 May 2019. Results: Based on the investigation, Of the 303 villagers involved in the event, 188 villagers were ill with the median age of cases was 38 years old, the average incubation period was 8 hours, and the predominant symptoms were diarrhea (93.62%), nausea (84.57%), and abdominal cramps (64.89%). The contaminated chicken satay was determined as the source of contamination with an adjusted Risk Ratio (aRR) was 4.36; 95% CI 1.1538, 16.5285. Initial epidemiological features and cultures from food items served in the event and stool sample of one patient suggested that the causative agent was Bacillus Cereus which was supported by Klebsiella Pneumoniae . Conclusion: Based on the field investigation result related to symptoms and incubation period and laboratory identification, we conclude that the causative agent was diarrhoeal B. cereus .

Introduction: Food poisoning is an acute gastroenteritis caused by ingestion of food or drink contaminated with either living bacteria or their toxins or inorganic chemical substances and poisons derived from plants and animals, commonly occurring as explosive outbreaks. The authors investigated an outbreak of food poisoning reported from a working men's hostel in urban area of Pune, Maharashtra. Materials and Methods: A retrospective cohort study design was adopted to investigate the outbreak. Of the total 170 members, 68 had symptoms of food poisoning. Remaining 102 unexposed members were also interviewed as part of the study. Data for environmental and laboratory parameters were also collected. Results: The point source outbreak indicated cooked chicken as the source with a risk ratio of 3.34 (95% confidence interval: 2.02–5.54) and attributable fraction for chicken was 75.3%. As is the case with 70% of food poisoning outbreaks, laboratory confirmation of causative organism could not be established, due to lack of specimens. However, the clinicoepidemiological profile of the patients displays a median incubation period of 8 h (range 5–17 h), along with the clinical symptomatology of a self-limiting disease of diarrhea, abdominal cramps, and nausea; suggested the implicating organisms to be either Clostridium perfringens or Bacillus cereus. Conclusion: The defaulting environmental parameters of compromised sanitary conditions, inadequate storage in refrigerator, improper storage of raw food, and unsafe cooking practices were enhancing factors, which need to be mandatorily addressed in bulk cooking.

Since a number of heat-resistant Clostridium perfringens have often been harbored in the intestine of a normal healthy people: 1) It is necessary to confirm complete agreements in the sero-type of the isolates of incriminated foods and of patient feces, when we make a retrospective laboratory diagnosis on food poisoning cases in which Cl. perfringens have been suspected as a causal agent. 2) If we failed to obtain the incriminated food, it becomes more difficult to determine the causal agent. viz., it is required to prove that more than 90% of the patients is discharging the same sero-type of organism within their 3rd day of the illness, and more than 70% on their 7th day respectively.During 1963-69, there were 9 cases of outbreak of food poisoning due to heat-resistant Cl. perfringens in Tokyo. These are summerized as follows;Case 1: On 20-21st of September 1963, a large scale food poisoning occurred, affecting a total of 1, 491 out of 1, 968 employees (affection rate 75.8%) of the 38 companies, who took a lunch delivered by the same caterer. The patients complained of diarrhea and abdominal pain within 8-15 hours after the ingestion of the lunch. Boiled whale meat contained in the lunch was supposed to be the incriminated food, which had been allowed to stand at room temperature overnight after cooking. Hobbs' type 4 organism was isolated from the meat. On the other hand, on the 3rd day of the illness, Hobbs' type 1 and 4 were isolated from 293 of 379 feces of the patients. From the fact, as shown in Table 2, the outbreak was presumed to be combined infection with both of Hobbs' type 1 and 4 organisms.Case 2: On 17-18th of July 1964, 183 out of 242 persons (75.6%) who had eaten pickled horse-mackerel for their lunch at the employees' canteen, complained of diarrhea and abdominal pain. Ninety-nine of 183 feces (71.0%) of the patients, collected on the 7th day of the illness, were positive Hobbs' type 5 organisms. It was then diagnosed as a food poisoning case due to the heat-resistant Cl. perfringens Hobbs' type 5, although the incriminated food was not available.Case 3: On 3-4th of September 1964, 165 out of 232 persons (71.1%) who took “Inarisushi” one of the Japanese meal for their lunch at the employees' canteen, complained of diarrhea and abdominal pain. Average incubation period was 12.5 hours, and heat-resistant organism Hobbs' type 13 was isolated from 35 of 39 patients (89.7%) on the 3rd day of the illness. Then, it was suspected to be a food poisoning case due to the heat-resistant Cl. perfringens Hobbs' type 13.Case 4: On 28-30th of April 1966, a total of 657 out of 892 persons (73.7%) of 49 companies, who took Scotch egg for their lunch, which was delivered by the same caterer, complained of diarrhea (86.1%) and abdominal pain (66.1) within 5-30 hours after the ingestion of the lunch. Twenty-two point two per cent of the patient complained of their dullness, but few nausea and vomiting. Hobbs' type 2 (2.8×106) and 4 organism (2.4×106) were detected from 1 gram of scotch egg. Detection rate of the organisms from the patients were 92.7% on the 1-3rd day of the illness. Among the 1, 765 strains of the isolates, 375 strains (21.2%) were typed into Hobbs' type 2, and 1, 133 strains (64.2%) into Hobbs' type 4 respectively. Accordingly, the outbreak would be due to combined infection with Hobbs' type 2 and 4 organisms.Case 5: On 29th of April 1967, a food poisoning occurred at a certain inn in Kanagawa prefecture, affecting 152 out of 244 persons (62.3%) who had happen to stay at that inn, manifested a typical symptoms of the food poisoning, although failed to point out the incriminated food. Hobbs' type 1 organism was isolated from the feces of all 8 patients on the 4th day of the illness and presumably the cause of the outbreak.

This article aims to help physicians to make a differential diagnosis of food poisoning by introducing the incubation period, clinical symptoms of each causative agent according to the mode of manifestation. Etiologic agents for food poisoning are classified as bacterial, viral, natural toxin, and chemical toxin. Bacterial food poisoning is classified as infectious type, toxin type and other type according to the pathogenesis. Natural toxin food poisoning are classified as plant and animal food poisoning according to causative food. Many of the diagnoses are made clinically, without confirmative laboratory tests. However, some of food poisonings require the confirmative etiologic diagnoses, because they have rapid life-threatening courses and need proper speedy therapies. When incubation period is 1-6 hours, natural toxin type food poisoning should be suspected such as Staphylococcus aureus, Bacillus cereus vomiting type. When it is 7 to 12 hours, Clostridium perfringens and Bacillus cereus diarrheal type should be suspected. When it is 12 to 72 hours, Enterotoxigenic Echerichia coli, Salmonella spp., Vibrio parahemolyticus and Norovirus should be suspected. Before the result of confirmative laboratory test, a probable diagnosis for the etiology of food poisoning should be based upon the combination of their clinical manifestations, food histories, and pathogenic mechanisms.

Symptoms of acute food poisoning developed in eight members of a group who ate lunch at a cafeteria. After brief incubation periods, all affected individuals complained of nausea and abdominal cramps. Four persons promptly experienced vomiting. None of those affected was found to have fever and all recovered with 48 hours. Epidemiologic investigation incriminated macaroni and cheese as a cause of the illness and samples of this food contained large numbers of Bacillus cereus. Previous outbreaks of B cereus emetic food poisoning have been associated with consumption of contaminated fried rice and may occur after ingestion of other foods.

BackgroundUnderstanding the epidemiological parameters that determine the transmission dynamics of COVID-19 is essential for public health intervention. Globally, a number of studies were conducted to estimate the average serial interval and incubation period of COVID-19. Combining findings of existing studies that estimate the average serial interval and incubation period of COVID-19 significantly improves the quality of evidence. Hence, this study aimed to determine the overall average serial interval and incubation period of COVID-19.MethodsWe followed the PRISMA checklist to present this study. A comprehensive search strategy was carried out from international electronic databases (Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library) by two experienced reviewers (MAA and DBK) authors between the 1st of June and the 31st of July 2020. All observational studies either reporting the serial interval or incubation period in persons diagnosed with COVID-19 were included in this study. Heterogeneity across studies was assessed using the I2 and Higgins test. The NOS adapted for cross-sectional studies was used to evaluate the quality of studies. A random effect Meta-analysis was employed to determine the pooled estimate with 95% (CI). Microsoft Excel was used for data extraction and R software was used for analysis.ResultsWe combined a total of 23 studies to estimate the overall mean serial interval of COVID-19. The mean serial interval of COVID-19 ranged from 4. 2 to 7.5 days. Our meta-analysis showed that the weighted pooled mean serial interval of COVID-19 was 5.2 (95%CI: 4.9–5.5) days. Additionally, to pool the mean incubation period of COVID-19, we included 14 articles. The mean incubation period of COVID-19 also ranged from 4.8 to 9 days. Accordingly, the weighted pooled mean incubation period of COVID-19 was 6.5 (95%CI: 5.9–7.1) days.ConclusionsThis systematic review and meta-analysis showed that the weighted pooled mean serial interval and incubation period of COVID-19 were 5.2, and 6.5 days, respectively. In this study, the average serial interval of COVID-19 is shorter than the average incubation period, which suggests that substantial numbers of COVID-19 cases will be attributed to presymptomatic transmission.

E­ste trabalho objetivou descrever uma investigação de surto de intoxicação alimentar em um evento realizado no município de Campinas/SP, avaliando as possíveis causas e identificando os agentes etiológicos. Para isso, foram analisados documentos utilizados na investigação epidemiológica (entrevista com comensais), sanitária (roteiro de inspeção sanitária baseado nas legislações vigentes) e laboratorial (análises de alimentos e de material clínico de três pacientes). A investigação epidemiológica mostrou se tratar de uma intoxicação alimentar, ao passo que a investigação sanitária revelou uma série de irregularidades na empresa produtora dos alimentos, como por exemplo, ausência de licença de funcionamento, exposição dos alimentos a temperaturas inadequadas e condições higiênicas ambientais insatisfatórias, sendo essas últimas condições que favorecem e facilitam a multiplicação de agentes patogênicos. A investigação laboratorial confirmou os agentes bacterianos suspeitos de causar o surto (Bacillus cereus e Staphylococcus aureus) a partir de amostras de sobras de esfiha de carne e de torta de legumes, sustentando as suspeitas obtidas nas investigações sanitária e epidemiológica. O êxito desta investigação se deu a partir da ação integrada de diferentes especialidades oficiais, em esforço mútuo para elucidar as causas­ da ocorrência e a confirmação etiológica, subsidiando as ações políticas de prevenção das doenças transmitidas por alimentos.

Outbreak of food poisoning in Indonesia for the period 2000-2015, the results of research using a systematic and quantitative study approach stated that outbreaks were increasing every year. 60% of food poisoning is thought to be caused by bacteria, without being proven by laboratory test results that the cause of the outbreak is bacteria. The highest causative pathogenic bacteria in food poisoning cases include Escherichia coli, Bacillus cereus, Staphylococcus sp., Salmonella. The purpose of this study was to determine the relationship of hygiene, food sanitation and restaurant sanitation with the bacteriological quality of restaurants in the port of Tirtonadi Surabaya in 2020. This research is analytical descriptive research and reviewed from time aspect is cross sectional. Number of sample is total population that is 17 restaurant in the Tirtonadi port of Surakarta. This research conducts in observasionally and laboratory test method with using Exact Fisher test. Research result of restaurant hygiene and sanitation is 82%. For microbe E.Coli existence is positive in 2 restaurant obtain microbe E.Coli. This show that there is correlation between hygiene, food sanitation and restaurant sanitation to quality of food bacteriological with each P= 0,022. The Conclusion is correlation between hygiene, restaurant sanitation and food sanitation is axist toward quality of food bacteriological. Management of food hygiene by restaurant must need sanitation and food-processing done in the way of good.

An outbreak of acute gastroenteritis occurred in September 2006 in a boarding school in eastern Austria. Of 113 cases, 101 were hospitalised. In order to identify the outbreak source, a retrospective cohort study on the group at risk was performed, including 222 pupils and 30 staff members. Food exposure in the canteen of the school was identified as the most relevant common link among the cases in the case series investigation. Although the preliminary microbiological investigation made Norovirus infections possible, an in-depth descriptive epidemiological investigation later pointed to food intoxication rather than a viral infection as the cause of the outbreak. The analytical epidemiological investigation implicated boiled rice and chicken wings served in the canteen as the most likely source of the outbreak. Staphylococcus aureus was identified as the causative agent. Further molecular characterisation revealed that the predominant S. aureus type in this outbreak was a new spa type, t2046. The same spa type was isolated from stool specimens of the majority of the cases investigated, from samples of the incriminated boiled rice, and also from a swab of a palmar skin lesion of one of the healthy kitchen workers, who is therefore the most likely source of contamination. This outbreak underlines again the importance of compliance with the basic guidelines for kitchen hygiene.

Bacillus cereus is an emerging food-borne pathogen responsible for two types of food poisoning: emetic and diarrhoeal type. Here we report an emetic type of food-borne illness attributable to Bacillus cereus. On 2nd February, 2021, 202 people suffered from pain in abdomen and vomiting after consuming the rice provided during a public gathering in Diphu, Assam. Culture of leftover fried rice showed growth of Bacillus cereus group of organisms. Molecular detection of enterotoxin and emetic toxin genes was done in the isolated strains by polymerase chain reaction. Multi locus sequence typing (MLST) and phylogenetic analysis was done to characterise the isolated strains. A total of five strains of Bacillus cereus were isolated. Ces gene was found in isolates GMC22 & GMC24 and other enterotoxins producing genes were found in isolates GMC23 and GMC24. MLST identified four sequence types (STs) (ST1051, ST1616, ST998 and ST1000). Phylogenetic analysis clustered ST-1051 assigned to the GMC22 strain into the previously defined clade I and was in close relation with ST-144, representing a new cereulide-producing emetic cluster. As Bacillus cereus is a common contaminant of foods, it is essential to evaluate the pathogenic potential of the bacteria for a definite link between causative agents and the illness. MLST can be used to characterize the Bacillus cereus strains isolated from outbreak samples in order to link the probable pathogens with the illness. In this outbreak, we suggest that ST-1051 is the strain responsible for the food-borne illness, which was predominantly of emetic type.

An unusual food-borne outbreak of gastroenteritis associated with contaminated turkey occurred at a catered company meal. The average incubation period was 10 h, and the predominant symptoms were watery diarrhea and cramps. Vomiting did not occur. Initial epidemiological features and cultures from turkey and feces of infected patients suggested that the causative agent was Clostridium perfringens, but Klebsiella pneumoniae of capsular type K15 was also isolated in large numbers from both the turkey and feces of the same patients. Plasmid analysis and enterotoxin results supported the role of K. pneumoniae as the causative agent in this outbreak. Organisms other than commonly identified pathogens should not be ignored if present in high concentrations in both food and feces of infected persons.

Fruit salad is one food combination that often causes food poisoning because it contains cheese and milk. This study aims to analyze the bacterial contamination that causes food poisoning in fruit salads sold in Banjarbaru, Indonesia, and the factors that play a role in such pollution. Food poisoning from fruit salad can be anticipated by knowing bacterial contamination and the factors that play a role in it. This study uses an observational method with a cross-sectional design. The sample in this study was fruit salads from 18 different producers sold in Banjarbaru, Indonesia. Fruit salad with criteria containing fruit, cheese, and mayonnaise. The bacteria that caused food poisoning to find in the fruit salad, namely Staphylococcus aureus, and Bacillus cereus. In conclusion, his research found the contamination of bacteria that cause food poisoning in Fruit Salad in Banjarbaru City with a percentage of 22 percent. The types of bacteria are Staphylococcus aureus (11 percent) and Bacillus cereus (11 percent). It recommends that salad sellers wash their hands before processing, use running water to wash fruit, and use secure salad packaging.

Objectives: In the present study, a food poisoning outbreak was reported from a medical officer in-charge of the temporary camp, where a largegathering of around 400 boys and girls had consumed meal from a common kitchen during training event. Thus, the main objective of the study was to investigate the outbreak and institute preventive measures. Methods: The camps had a total strength of 400. Ten individuals reported with history of vomiting and diarrhea. Mixed methodology approach was used to carry out epidemiological investigation. Inspection of cookhouse and surroundings was carried out. Results: Ten individuals were affected. A short incubation period ranging from 4 to 6 h with median incubation of 5 h. Among cases, all had diarrhea with the number of episodes ranging from 3 to 5. Seven patients had vomiting (70%), two (20%) patients had blood in stools, and none reported with abdominal cramps and fever. A total of five food items were suspected for food poisoning. However, none had a significant association with outcome. In depth interview and descriptive analysis revealed that mayonnaise in sandwich was the cause for food poisoning. Conclusion: Food poisoning outbreak is a common occurrence now days. Hygiene and sanitation of cookhouse to be carried out routinely to prevent outbreak. Individuals in camps should also be educated of 5 Key points of food safety by the WHO.

Detection of Bacillus cereus as a causative agent of emetic food poisoning by an unconventional culture procedure

*Summary To determine the prevalence of bacterial mastitis in cattle, milk samples positive for California mastitis test (CMT) were cultured during a period of almost 4 years. The bacterial species isolated from 2904 milk samples studied were coagulase negative Staphylococcus sp. in 879 (30.27%) samples, Streptococcus agalactiae in 642 (22.11%), S. dysgalactiae in 332 (11.43%), E. coli in 295 (10.16%), Staphylococcus aureus in 84 (2.89%), Bacillus cereus in 51 (1.76%), Arcanobacterium pyogenes in 31 (1.07%), Pseudomonas aeruginosa in 6 (0.21%), Klebsiella pneumoniae in 4 (0.14%), Pasteurella multocida in 1 (0.03%) and Mycoplasma sp. in another (0.03%) sample. No growth was found in 578 samples (19.90%). Thirty-one (37%) of 84 animals which were infected with S. aureus, had acute infection. We found that contamination of milk with coagulase negative staphylococci are the most frequent bacterial infection in dairy cattle around Tehran; it mostly causes subacute form of the disease. S. agalactiae, S. dysgalactiae and E. coli are the second, third and the fourth causative agents.