title: Time to B. cereus about hot chocolate.
abstract: OBJECTIVE
  To determine the cause of illnesses experienced by employees of a Minneapolis manufacturing plant after drinking hot chocolate bought from a vending machine and to explore the prevalence of similar vending machine-related illnesses.
  
  
  METHODS
  The authors inspected the vending machines at the manufacturing plant where employees reported illnesses and at other locations in the city where hot chocolate beverages were sold in machines. Tests were performed on dry mix, water, and beverage samples and on machine parts.
  
  
  RESULTS
  Laboratory analyses confirmed the presence of B. cereus in dispensed beverages at a concentration capable of causing illness (170,000 count/gm). In citywide testing of vending machines dispensing hot chocolate, 7 of the 39 licensed machines were found to be contaminated, with two contaminated machines having B. cereus levels capable of causing illness.
  
  
  CONCLUSIONS
  Hot chocolate sold in vending machines may contain organisms capable of producing toxins that under favorable conditions, can induce illness. Such illnesses are likely to be underreported. Even low concentrations of B. cereus may be dangerous for vulnerable populations such as the aged or immunosuppressed. Periodic testing of vending machines is thus warranted. The relationship between cleaning practices and B. cereus contamination is an issue for further study.
authors.affiliation: Minneapolis Department of Health and Family Support (MDHFS), MN 55415, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Nelms
authors.forename: O
authors.initials: O
authors.lastname: Larson
authors.forename: D
authors.initials: D
authors.lastname: Barnes-Josiah
mesh_terms: D001409:Bacillus cereus / Q000302:isolation & purification*; D001628:Beverages / Q000382:microbiology*; D002099:Cacao / Q000382:microbiology*; D004196:Disease Outbreaks; D004866:Equipment Contamination; D005509:Food Dispensers, Automatic; D006801:Humans; D008910:Minnesota / Q000453:epidemiology; D009325:Nausea / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence