Staphylococcal food-poisoning

Staphylococcal food-poisoning occurs as the result of the ingestion of a heat-stable,

preformed enterotoxin produced byS. aureus. It is considered to be one of the most
frequently occurring food-borne diseases worldwide.

The organism

S.aureus is a gram positive coccus bacterium, generally occur in grape-like clusters.

Growth on solid medium is usually golden or yellow. Most of the strains producing
coagulase (coagulating blood plasma), thermonuclease and are facultative in their oxygen
requirements. They are mesophiles with fairly rapid growth between 20 and 37 C. They are
able to grow at relative low Aw (0.86), low pH (4.8) and high salt concentrations (7-
10%).

Sources

The two most important sources to foods are nasal carriers and individuals whose hands
and arms are inflicted with boils and carbuncles, who are permitted to handle foods.
Generally, air is a relative unimportant source of the staphylococci, except when they are
being introduced there from human sources.

The Enterotoxin

S. aureus produce 13 different enterotoxins; A, B, C1, C2, C3, D, E, G, H, I, J, K and L (also

designated as SEA, SEB etc). They are serologically distinct, proteins of molecular weight
26-30 kDa and differ in toxicity. The enterotoxins are quite heat resistant. In general, the

heat resistance of SEA, SEB and SEC is SEC >SEB >SEA. In foods, the enterotoxins are not

completely inactivated by normal cooking.

Mode of action

Despite being classified as enterotoxins, they are presumed to function by affecting neural
receptors in the gut, which stimulate the emetic and diarrheal response. Recently, the

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enterotoxins have also been categorized as superantigens due to their ability to stimulate
cytokine production by helper T cells. Among the cytokines, an overabundance of IL-2 is
produced and it appears to be responsible for most of the symptoms of staphylococcal
food-poisoning.

The Disease

The symptoms usually develop within 4 hours of the ingestion of contaminated food,
although a range of 1–6 hours has been reported. The principal symptoms include nausea,
vomiting, abdominal cramps and diarrhea. Headache, prostration, sweating, chills and
sometimes a fall in body temperature may occur. Symptoms generally last for 1-2 days
and the mortality rate is very low. No treatment is given, except in extreme cases, where
saline solutions may be given parenterally to restore the salt balance and counteract
dehydration.

Foods Involved

Of the many kinds of foods that have been involved in causing staphylococcal food
poisoning, custard and cream-filled bakery goods, ham and poultry have caused the most
outbreaks. Other foods incriminated include meat and meat products, fish and fish
products, milk and milk products, salads, puddings, pies and salad dressings. In many
outbreaks, the food is cooked, then contaminated with S. aureus during handling and held
at a temperature for growth and production of enterotoxin.

Prevention of Outbreaks

The means of prevention of outbreaks of staphylococcal food poisoning include -

(1) Prevention of contamination of the food with the staphylococci

(2) Prevention of the growth of the staphylococci and
(3) Killing staphylococci in foods

Contamination of foods can be reduced by general methods of sanitation, by using

ingredients free from the staphylococci e.g. pasteurized rather than raw milk and by

[2]
keeping employees away from foods when these workers have staphylococcal infections in
the form of colds, boils and carbuncles etc. Growth of the staphylococci can be prevented
by adequate refrigeration of foods. Some foods may be pasteurized to kill the
staphylococci before exposure of the foods to ordinary temperatures.

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