Bacteria and poisonous plants were the primary causative hazards of foodborne disease outbreak: a seven-year survey from Guangxi, South China

Attribution Analysis of Household Foodborne Disease Outbreaks in China, 2010-2020

Foodborne diseases have become a serious public health problem worldwide, and foodborne disease outbreaks have placed a heavy disease burden on China. Foodborne disease outbreaks occur most frequently among families in China. The objectives of this study were to analyze the cause of household foodborne disease outbreaks in China from 2010 to 2020 and to identify where preventive measures could be targeted. All data were obtained from the China Foodborne Disease Surveillance System Report. A total of 17,985 outbreaks, which resulted in 73,252 illnesses, 38,829 hospitalizations, and 1269 deaths, were reported in this period. Most household outbreaks of foodborne diseases occurred in May-October, and the highest number occurred in July (3620 outbreaks, 20%). The province with the highest number of outbreaks was Yunnan Province (4829 outbreaks), followed by Hunan Province (2264 outbreaks). The attribution analysis revealed that fungi (mainly poisonous mushrooms) were the most implicated food category, with 8873 (49.3%) cases. The second was poisonous plants and their products, with 1552 (8.6%) cases. Fungi were the primary etiologic agent, with 31,125 illnesses, accounting for 42.5% of the incidents. Inedibility and misuse (9423 outbreaks), unknown origin (2505 outbreaks), and improper processing (2365 outbreaks) were the main contributing factors causing outbreaks of foodborne diseases. The results show that southwest China was a high-risk area for household foodborne diseases. Therefore, public health institutions should strengthen supervision and food safety education of residents to reduce the outbreaks of household foodborne diseases.

Bacteria and poisonous plants/fungi were the primary causative hazards of foodborne disease outbreaks: A five-year survey from Guangzhou, Guangdong

The burden of foodborne diseases is of serious concern. More effective and localized intervention policies for outbreak prevention and management are required; however, policy modification is hampered due to a lack of information on the epidemiological characteristics of outbreaks in Guangzhou. We collected data from 182 foodborne disease outbreaks reported in Guangzhou, China from 2017 to 2021 to investigate the epidemiological characteristics and associated factors. Nine outbreaks were serious enough to be labelled as level IV public health emergencies, all of which were associated with canteens. In terms of the number of outbreaks, morbidity and clinical medical needs, bacteria and poisonous plants/fungi were the primary causative hazards of outbreaks, and were found mostly in foodservice establishments (96 %, 95/99) and private homes (86 %, 37/43) respectively. Surprisingly, Vibrio parahaemolyticus was primarily identified in meat and poultry products rather than in aquatic products in these outbreaks. Patient specimens and food samples were among the most common sources of detected pathogens in foodservice establishments and private homes. Cross-contamination (35 %), improper processing (32 %) and equipment/utensil contamination (30 %) were the top three risk factors for outbreaks related to foodservice establishments, while accidental ingestion of poisonous food (78 %) was the most common risk factor in private homes. Based on the above epidemiological characteristics of the outbreaks, key foodborne disease intervention policy points should be to raise public awareness of harmful food and avoid risk behaviour, improve handler hygiene training, and strengthen the hygiene management and supervision of kitchens, especially canteens in collective units.

Preparation of polyclonal antibody against a universal bacterial antigen OmpA deduced by bioinformatic analysis and preliminary evaluation of concentration effects on foodborne pathogens

Rapid and ultrasensitive microbial detection in actual samples have challenges because of target pathogen diversity and low abundance. In this study, we attempted to capture and concentrate multiple pathogens by combining magnetic beads with polyclonal antibodies against a universal antigen of ompA, LAMOA-1, before further detection. A protein sequence consisting of 241 amino acids with spatial conformation similar to E. coli ompA was identified and expressed as a recombinant protein in prokaryotes according to the results of sequence alignment among 432 sequences of ompA belonging to intestinal bacteria from gram-negative bacteria. Purified from immunized rabbits, the anti-LAMOA-1 antibody was shown to effectively recognize 12 foodborne bacterial species. Antibody-conjugated beads were used to concentrate the bacteria when the bacterial concentration in artificially contaminated samples is between 10 and 100 CFU/mL, which shortens detection duration by 8-24 h. The enrichment strategy is potentially beneficial for detection of foodborne pathogens.

Lactate and blood ammonia on admission as biomarkers to predict the prognosis of patients with acute mushroom poisoning and liver failure: a retrospective study

The diagnosis of liver damage induced by mushroom poisoning is still challenging. This study aims to screen the early biological indexes that could predict acute mushroom poisoning with liver damage. The patients with acute mushroom poisoning and liver damage admitted to The First Affiliated Hospital of Dalian Medical University，China from July 2007 to August 2017 were analyzed retrospectively. A total of 66 patients were enrolled in this study, with 44 and 22 patients in the liver injury group and liver failure group, respectively. Ten patients in the liver failure group died, with a mortality of 45.5% in this group. Multivariable Cox regression showed that the blood ammonia (NH3) and lactic acid (Lac) at the time of admission were independently associated with the in-hospital time to death for patients with liver failure induced by mushroom poisoning. Lactate and blood ammonia at the time of admission could be used to predict the prognosis of patients with acute mushroom poisoning and liver failure.

Diversity of Serotype, Genotype, and Antibiotic Susceptibility of Salmonella Prevalent in Pickled Ready-to-Eat Meat

Pickled ready-to-eat meat (PRTEM) is a meat product that is treated with various seasonings and then cooked. PRTEM is a popular food consumed mostly in China and some Asian countries. Since this food is considered 'ready to eat', once it is contaminated by foodborne pathogens such as Salmonella, the prospect for significant morbidity, mortality, and immeasurable economic losses can occur. Here we investigated the prevalence and concentration of Salmonella in 107 PRTEM samples collected from Shaanxi, China during 2015-2016. Furthermore, we analyzed the serotype, antibiotic susceptibility, and presence of antibiotic resistance genes and amino acid mutations in 219 Salmonella isolates, followed by subtyping of 115 representative isolates. The average detection rate of Salmonella-positive PRTEM was 58.9%, and the average most probable number (MPN) of Salmonella in positive samples was 2.27 logMPN per gram of sample (range: 2.10-2.43). Ten serotypes were identified from the 219 Salmonella isolates, with S. Thompson (37.9%) and S. Indiana (20.5%) being predominant. The remaining serotypes were S. Typhi (7.8%), S. Typhimurium (7.3%), S. Mbandaka (6.9%), S. Albany (6.4%), S. Blockley (5.5%), S. Infantis (4.1%), S. Escanaba (3.2%), and S. Dusseldorf (0.5%). All isolates were resistant to ceftiofur (100%), while most of them were resistant to ciprofloxacin (99.1%), amoxicillin-clavulanic acid (97.7%), trimethoprim-sulfamethoxazole (96.4%), ampicillin (92.3%), sulfisoxazole (92.2%), tetracyclines (90.4%), and nalidixic acid (90.4%), respectively. A single mutation of Ser83Phe (27.1%) and double mutations of Ser83Phe-Asp87Gly (25.9%) in GyrA were detected in 85 isolates, whereas mutations of Thr57Ser (63.9%) and Ser80Arg (36.1%) in ParC were detected in 122 isolates. qnrB, oqxAB, aac(6')-Ib, and qnrA were present in 50 (22.8%), 48 (21.9%), 26 (11.9%), and 1 (0.5%) isolate(s), respectively. Pulse field gel electrophoresis results revealed that those isolates recovered from the same type of PRTEM or the same sampling place shared identical or similar DNA profiles, antibiotic resistance phenotypes, and even plasmid-mediated quinolone resistance encoding genes. The findings indicate that Salmonella is commonly prevalent in PRTEMs at high concentrations in Shaanxi, China. More attention should be paid to the processing and storage of this ready-to-eat food to prevent bacterial contamination and foodborne outbreaks.

Overview of Foodborne Disease Outbreaks in Brazil from 2000 to 2018

This study aimed to assess the foodborne diseases (FBD) outbreaks reported in Brazil between 2000 and 2018, based on data from the Brazilian Ministry of Health (official data) and from scientific literature. According to official data, 13,163 FBD outbreaks were reported in the country during this period, involving 247,570 cases and 195 deaths. The largest prevalence of FBD outbreaks was observed in the Southeast region of Brazil (45.6%). In most outbreaks it was not possible to determine the food implicated (45.9%) but among those identified, water was the most frequently associated (12.0%). The etiological agent was not identified in most outbreaks (38.0%), while Salmonella (14.4%) was the most frequently reported among those identified. Homes were the main site of FBD occurrence (12.5%). Regarding data obtained from the scientific literature, 57 articles dealing with FBD in the country throughout the same period were selected and analyzed. Based on these articles, mixed foods were the most prevalent in the outbreaks (31.6%), Salmonella spp. was the pathogen most frequently reported (22.8%) and homes were also the main site of FBD occurrence (45.6%). Despite under-notification, the records of FBD outbreaks that have occurred in Brazil in the past recent years show alarming data, requiring attention from health authorities. The notification of outbreaks is essential to facilitate public health actions.

Descriptive Study of Foodborne Disease Using Case Monitoring Data in Shandong Province, China, 2016-2017

BACKGROUND

In order to generate data on the burden of foodborne diseases in Shandong Province, we aimed to use the case monitoring data of foodborne diseases from 2016 to 2017 to estimate.

METHODS

Data were obtained from the foodborne disease surveillance reporting system with dates of onset from Jan 1, 2016, to Dec 31, 2017, in Shandong, China.

RESULTS

The places of food exposure were categorized by settings as follows: private home, catering facility, collective canteens, retail markets, rural banquets and other. Exposed food is divided into 23 categories. Overall incidence rate and proportions by exposure categories, age, and sex-specific incidence rates were calculated and sex proportions compared. Approximately 75.00% of cases who had at least one exposure settings were in private homes. The most frequently reported exposed food was a variety of food (meaning more than two kinds of food). The two-year average incidence rate was 75.78/100,000, sex-specific incidence rate was much higher for females compared to males (78.23 vs. 74.69 cases per 100,000 population). An age-specific trend was observed in the cases reported (Chi-Square for linear trend, χ²=4.39, P=0.036<0.05).

CONCLUSION

A preliminary estimate of 14 million cases of foodborne diseases in Shandong province each year. Future studies should focus on cross-sectional and cohort studies to facilitate the assessment of the distribution and burden of foodborne disease of the population in Shandong. Considering strengthening the burden of foodborne diseases in foodborne disease surveillance is also a feasible way.