title: [Allergy due to probable contamination of bread used for school meals with milk].
abstract: BACKGROUND
  In May 2012, two schoolchildren developed allergic symptoms after eating a school meal of fried bread in Osaka, Japan. One specific raw material, milk, should not be present in fried bread. However, we suspected the unintentional mixing of milk in the bread manufacturing process. Our aim was to verify the reason if this was so.
  
  
  METHODS
  We first manufactured bread that contained milk as one of its components. We then thoroughly cleaned the manufacturing line except for the dough divider and, as per the revised instruction manual, continuously manufactured bread that did not contain milk. In this manner, we tried to simulate the conditions at the time of the incident. Casein is a major milk protein. We, therefore, determined casein concentration in the milk-free bread, using casein enzyme-linked immunosorbent assay.
  
  
  RESULTS
  We observed casein levels higher than 1000 ppm in the initial lots of breads, but lower levels in the later lots. Casein levels also decreased upon frying of bread.
  
  
  CONCLUSIONS
  High casein levels, which were observed in the earlier lots of breads, were lower in the later lots. In the manufacturing line, the remnants of the bread dough that contained milk presumably got mixed with the dough used in the subsequent manufacture of milk-free bread.
authors: Division of Food Chemistry, Osaka Prefectural Institute of Public Health.
authors: Kyohei
authors: K
authors: Kiyota
authors: Central Region Block, Osaka Prefectural Council of Food Sanitation Inspectors.
authors: Yuka
authors: Y
authors: Fujiwara
authors: Central Region Block, Osaka Prefectural Council of Food Sanitation Inspectors.
authors: Kazuto
authors: K
authors: Adachi
authors: Osaka Prefectural Medical Center for Respiratory and Allergic Diseases.
authors: Makoto
authors: M
authors: Kameda
authors: Division of Food Chemistry, Osaka Prefectural Institute of Public Health.
authors: Kazuhiko
authors: K
authors: Akutsu
authors: Division of Food Chemistry, Osaka Prefectural Institute of Public Health.
authors: Keiji
authors: K
authors: Kajimura
mesh_terms: D001939:Bread / Q000009:adverse effects*; D002364:Caseins / Q000032:analysis; D002648:Child; D005506:Food Contamination; D005511:Food Handling; D006801:Humans; D016269:Milk Hypersensitivity / Q000276:immunology*; D012574:Schools
chemical_list: D002364:Caseins