title: An emetic Bacillus cereus outbreak in a kindergarten: detection and quantification of critical levels of cereulide toxin.
abstract: A Bacillus cereus-related emetic outbreak was reported in a Belgian kindergarten. High levels of emetic B. cereus (>1.5E+07 colony-forming units/g) were detected in the food leftovers, and the presence of an emetic strain was confirmed in feces. Emetic toxin levels ranging up to 4.2 μg/g were also quantified in the leftovers by liquid chromatography coupled to tandem mass spectrometry (LC-MS(2)) analysis. Those levels, although moderate in comparison with earlier published intoxications, provoked profuse-vomiting episodes in 20 toddlers aged between 10 and 18 months. Few studies have focused on the levels of emetic toxin implicated in food intoxications. This publication emphasizes the importance of defining toxic doses of emetic toxin among high-risk population groups.
authors.affiliation: 1 Scientific Service Food-borne Pathogens, National Reference Laboratory for Food-borne Outbreaks, Scientific Institute of Public Health , Brussels, Belgium .
authors.forename: Laurence
authors.initials: L
authors.lastname: Delbrassinne
authors.forename: Nadine
authors.initials: N
authors.lastname: Botteldoorn
authors.forename: Mirjana
authors.initials: M
authors.lastname: Andjelkovic
authors.forename: Katelijne
authors.initials: K
authors.lastname: Dierick
authors.forename: Sarah
authors.initials: S
authors.lastname: Denayer
mesh_terms: D001409:Bacillus cereus / Q000472:pathogenicity*; D001530:Belgium / Q000453:epidemiology; D002853:Chromatography, Liquid; D015169:Colony Count, Microbial; D047630:Depsipeptides / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005506:Food Contamination / Q000032:analysis*; D005511:Food Handling; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D013234:Stem Cells; D053719:Tandem Mass Spectrometry; D014839:Vomiting / Q000382:microbiology
chemical_list: D047630:Depsipeptides; C089294:cereulide