CHINA – In a comprehensive decade-long study, researchers in China have delved into the sources and factors behind Bacillus cereus outbreaks, shedding light on crucial data that can guide efforts to prevent foodborne cases caused by this pathogen. 

The study, using data from the National Foodborne Disease Outbreak Surveillance System spanning from 2010 to 2020, unraveled a total of 419 Bacillus cereus outbreaks, leading to 7,892 cases, 2,786 hospital admissions, and sadly, five fatalities.

The study, published in China CDC Weekly, offers valuable insights into the patterns and sources of these outbreaks.

One significant discovery from the research was that the majority of Bacillus cereus outbreaks occurred during the summer months, particularly between May and September.

 The most recurrent food vehicle implicated in these outbreaks was linked to rice or flour-based products, particularly those involving rice or fried rice. 

Notably, school canteens were identified as frequent hotspots for these outbreaks, hinting at issues related to food contamination and improper storage during preparation. 

This underscores the importance of prioritizing food safety education and proper practices among canteen staff to curb future outbreaks.

School cafeterias and food safety oversight

The study highlights the heightened risk faced by students due to communal dining in schools and the challenges they encounter in assessing food quality. 

As a result, the researchers emphasized the need for supervisory bodies to enhance their oversight and management of food safety in school canteens. This proactive approach aims to reduce the frequency of Bacillus cereus outbreaks in educational institutions.

Bacillus cereus produces toxins that can lead to two types of foodborne illnesses: vomiting-type and diarrhea-type enterotoxins, characterized by symptoms such as nausea, vomiting, and diarrhea.

Outbreak trends and factors

The study also examined trends in Bacillus cereus outbreaks, with 2018 seeing the highest number of outbreaks (56), and 2012 registering the most cases. 

The peak in hospitalization rates occurred in 2011. While the majority of outbreaks originated in school cafeterias, the household setting had the highest hospitalization rate and mortality rate.

Multifactor contamination and mitigation measures

Researchers identified multifactor contamination as the primary cause of outbreaks, followed closely by improper storage. 

Food mishandling and ingestion errors were associated with the highest hospitalization rates. In addressing the risk of Bacillus cereus outbreaks, the researchers emphasized the importance of multiple control and management factors, including the use of safe food ingredients, standardized food processing, prevention of cross-contamination, thorough cooking practices, and proper preservation methods to inhibit the growth of Bacillus cereus.

This study serves as a critical resource for policymakers, health authorities, and food safety professionals, providing valuable insights into the prevention of Bacillus cereus outbreaks and the safeguarding of public health in China.

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