Published Date: 2004-09-22 23:50:00
Subject: PRO/EDR> Food poisoning, birthday guests - USA (FL)
Archive Number: 20040922.2619
FOOD POISONING, BIRTHDAY GUESTS - USA (FLORIDA)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 22 Sep 2004
From: ProMED-mail <email@example.com>
Source: Sun-Sentinal (Florida) [edited]
Dozens of guests at USD 80 000 birthday party end up with apparent food
A plastic surgeon's USD 80 000 birthday soiree at the Boca Raton Resort &
Club turned sour when he, and as many as 3/4ths of his guests, were
stricken by apparent food poisoning within a day. The Palm Beach County
Health Department is investigating whether tainted food from the Saturday
evening dinner led to severe diarrhea, vomiting, cramps, and headaches in
many of about 190 guests, health spokesman Tim O'Connor said on Tue 21 Sep
The party marked the 45th birthday of a West Palm Beach surgeon with a
sit-down dinner of lobster, filet mignon, steamed vegetables, risotto, and
cream pastries, said the doctor's wife. A shrimp and scallop appetizer was
served on a clam-shaped ice sculpture.
Health officials said that 70 out of 80 guests interviewed so far became
sick. State labs were testing samples from the kitchen and the guests,
looking for bacteria or contaminants, O'Connor said. State inspectors went
through the resort and found problems including refrigerators running too
warmly, but, "no glaring errors," O'Connor said.
Officials were looking at how the resort, and its suppliers, stored food
during the power outages of Hurricane Frances, he said. "We have to look at
everything," O'Connor said. "I think we can figure out where it came from."
The resort is conducting an investigation and is cooperating fully with the
Health Department, resort spokeswoman Anne Hersley-Hankins said.
[byline: Bob LaMendola]
[In the case of an illness with an incubation period of less than 12 hours
that is associated with vomiting without diarrhea, and without prominent
fever, staphylococcal food poisoning, due to ingestion of preformed
staphylococcal enterotoxin, is most likely. Given the cream-filled pastries
on the delightfully sounding birthday dinner menu, this probably
inadequately refrigerated dessert is the most likely vehicle.
The following is extracted from the USA FDA's Bad Bug Book
In the diagnosis of staphylococcal foodborne illness, proper interviews
with the victims, and the gathering and analyzing of epidemiological data,
are essential. Incriminated foods should be collected and examined for
staphylococci. The presence of relatively large numbers of enterotoxigenic
staphylococci is good circumstantial evidence that the food contains toxin.
The most conclusive test is the linking of an illness with a specific food,
or, in cases where multiple vehicles exist, the detection of the toxin in
the food sample(s).
In cases where the food may have been treated to kill the staphylococci, as
in pasteurization or heating, direct microscopic observation of the food
may be an aid in the diagnosis. A number of serological methods for
determining the enterotoxigenicity of _S. aureus_ isolated from foods, as
well as methods for the separation and detection of toxins in foods, have
been developed, and used successfully, to aid in the diagnosis of the
illness. Phage typing may also be useful when viable staphylococci can be
isolated from the incriminated food, from victims, and from suspected
carriers, such as food handlers.
A toxin dose of less than 1.0 microgram in contaminated food will produce
symptoms of staphylococcal intoxication. This toxin level is reached when
_S. aureus_ populations exceed 100 000 per gram.
Foods that are frequently incriminated in staphylococcal food poisoning
include meat and meat products; poultry and egg products; salads such as
egg, tuna, chicken, potato, and macaroni; bakery products such as
cream-filled pastries, cream pies, and chocolate eclairs; sandwich
fillings; and milk and dairy products. Foods that require considerable
handling during preparation, and that are kept at slightly elevated
temperatures after preparation, are frequently involved in staphylococcal
The true incidence of staphylococcal food poisoning is unknown for a number
of reasons, including poor responses from victims during interviews with
health officials; misdiagnosis of the illness, which may be symptomatically
similar to other types of food poisoning (such as vomiting caused by
_Bacillus cereus_ toxin); inadequate collection of samples for laboratory
analyses; and improper laboratory examination. Of the bacterial pathogens
causing foodborne illnesses in the USA (127 outbreaks, 7082 cases recorded
in 1983), 14 outbreaks, involving 1257 cases, were caused by _S. aureus_.
These outbreaks were followed by 11 outbreaks (1153 cases) in 1984, 14
outbreaks (421 cases) in 1985, 7 outbreaks (250 cases) in 1986, and one
reported outbreak (100 cases) in 1987.
Food poisoning crosses all social and economic boundaries. - Mod.LL]