Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-25T17:18:29.857Z Has data issue: false hasContentIssue false

A Hospital Cafeteria-Related Food-Borne Outbreak Due to Bacillus cereus: Unique Features

Published online by Cambridge University Press:  02 January 2015

Larry M. Baddour*
Affiliation:
Memphis and Shelby County Health Department and the, University of Tennessee, Memphis, Tennesse
Shelia M. Gaia
Affiliation:
Memphis and Shelby County Health Department and the, University of Tennessee, Memphis, Tennesse
Ronald Griffin
Affiliation:
Memphis and Shelby County Health Department and the, University of Tennessee, Memphis, Tennesse
Richard Hudson
Affiliation:
Memphis and Shelby County Health Department and the, University of Tennessee, Memphis, Tennesse
*
University of Tennessee, Memphis, Department of Medicine, Division of Infectious Diseases, 956 Court Avenue, H308, Memphis, TN 38163

Abstract

Although Bacillus cereus is a well-known cause of food-borne illness, hospital-related outbreaks of food-borne disease due to B. cereus have rarely been documented. We report a hospital employee cafeteria outbreak due to foods contaminated with B. cereus in which an outside caterer was employed to prepare the suspect meals. Data were collected from 249 of 291 employees who had eaten either of the two meals. With a mean incubation period of 12.5 hours, 64% (160 of 249) of employees manifested illness. Symptoms, which averaged 24.3 hours in duration, included diarrhea (96.3%), abdominal cramps (90%), nausea (50.6%), weakness (24.7%), and vomiting (13.8%). Eighty-seven employees sought medical attention, 84 of whom were seen in an emergency room. Although a significant difference was not demonstrated in food-specific attack rates, B. cereus was cultured from both rice and chicken items that were served at both meals. Sixty-three employees submitted stools for culture that grew no enteric pathogens, but none were examined for B. cereus. This food-borne outbreak demonstrates: (1) the need for hospital kitchen supervisors to ensure proper handling of food when outside caterers are employed; (2) that significant differences in food-specific attack rates may not be demonstrated in outbreaks, which may be related to several factors; and (3) the importance of notifying microbiology laboratory personnel when B. cereus is a suspect enteric pathogen, since many laboratories do not routinely attempt to identify this organism in stool specimens.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Terranova, W, Blake, PA: Bacillus cereus food poisoning. N Engl J Med 1978; 298:143144.Google Scholar
2.Goepfert, JM, Spira, WM, Kim, HU: Bacillus cereus. Food poisoning organism. A review. J Milk & Food Technology 1972; 35:213227.Google Scholar
3.Morris, JG Jr: Bacillus cereus food poisoning. Arch Intern Med 1981; 141:711.CrossRefGoogle ScholarPubMed
4.Giannetta, RA, Brasile, L: A hospital food-borne outbreak of diarrhea caused by Bacillus cereus: Clinical, epidemiologic, and microbiologic studies. J Infect Dis 1979; 139:366370.Google Scholar
5.Centers for Disease Control: Foodborne Disease Outbreaks Annual Summary 1982. U.S. Public Health Service, Atlanta, Georgia, 1985.Google Scholar
6.Todd, E, Park, C, Clecner, B, et al: Two outbreaks of Bacillus cereus food poisoning in Canada. Can J Public Health 1974; 65:109113.Google Scholar
7.Melling, J, Capel, BJ, Turnbull, PCB, et al: Identification of a novel enterotoxigenic activity associated with Bacillus cereus. J Clin Pathol 1976; 29:938940.CrossRefGoogle ScholarPubMed
8.Turnbull, PCB: Studies on the production of enterotoxins by Bacillus cereus. J Clin Pathol 1976; 29:941948.CrossRefGoogle ScholarPubMed
9.Mortimer, PR, McCann, G: Food-poisoning episodes associated with Bacillus cereus in fried rice. Lancet 1974; I:10431045.CrossRefGoogle Scholar
10.Kim, HU, Goepfert, JM: Occurrence of Bacillus cereus in selected dry food products. J Milk Food & Technology 1971; 34:1215.CrossRefGoogle Scholar
11.Tay, L, Goh, KT, Tan, SE: An outbreak of Bacillus cereus food poisoning. Singapore Med J 1982; 23:214217.Google Scholar
12.Raevuori, M, Kiutamo, T, Niskanen, A, et al: An outbreak of Bacillus cereus food-poisoning in Finland associated with boiled rice. J Hyg 1976; 76:319327.Google Scholar
13.Gilbert, RJ, Stringer, MF, Peace, TC: The survival and growth of Bacillus cereus in boiled and fried rice in relation to outbreaks of food poisoning. J Hyg 1974; 73:433444.Google Scholar
14.Decker, M, Booth, AL, Dewey, MJ, et al: Validity of food consumption histories in a food-borne outbreak investigation. Abstracts of the 12th Annual Educational Conference of the Association of Practitioners in Infection Control, May 13-17, 1985, Cincinnati, Ohio.Google Scholar
15.Schmitt, N, Bowmer, EJ, Willoughby, BA: Food poisoning outbreak attributed to Bacillus cereus. Can J Public Health 1976; 67:418422.Google Scholar
16.Midura, T, Gerber, M, Wood, R, et al: Outbreak of food poisoning caused by Bacillus cereus. Public Health Rep 1970; 85:4548.Google Scholar
17.Cash, RA, Music, SI, Libonati, JP, et al: Response of man to infection with Vibrio cholerae. II. Protection from illness afforded by previous disease and vaccine. J Infect Dis 1974; 130:325333.Google Scholar
18.Hornick, RB, Greisman, SE, Woodward, TE, et al: Typhoid fever: Pathogenesis and immunologic control. N Engl J Med 1970; 283:686691.Google Scholar