Aims: Salmonella is one of the most common foodborne illnesses worldwide. Poultry meat and products are the main sources of human infection. Therefore, the main objective of the current study was to assess the genetic virulence of biofilm-forming Salmonella isolated from chicken sausage and nuggets. Methodology and results: Isolation of Salmonella was carried out using XLD agar; suspected colonies were identified biochemically and then serotyped using the Kauffman-White scheme for detection of somatic (O) and flagellar (H) antigens. Congo red (CR) medium was used for the assessment of biofilm formation of the isolated strains. The invasion gene (invA), the heat-labile Salmonella enterotoxin gene (stn), plasmid-encoded fimbriae (pefA) genes, the protein effectors sopB, sopD and biofilm genes in six Salmonella isolates were investigated using mPCR, following QIAamp® DNA Mini Kit instructions and 1.5% agarose gel electrophoreses. Salmonella was detected in 12%, 8% and 4% of the examined frozen packaged raw chicken sausage, frozen packaged raw chicken nuggets and ready-to-eat sausage. The isolated strains were S. Typhimurium, S. Enteritidis, S. Essen and S. Montevideo. Moreover, mPCR indicated the presence of biofilm gene (csgD gene), stn, sopB and sopD virulence genes in all isolated strains (100%); however, pefA gene failed to be detected. Conclusion, significance and impact of study The current findings showed that every Salmonella isolate examined was capable of creating biofilm at room temperature. As a result, these isolates are more likely to persist on abiotic surfaces, which raises the danger of cross-contamination and foodborne outbreaks.
Salmonella Food Poisoning

BACKGROUND: In Asian countries, including Korea, lead poisoning caused by traditional herbal medicines is often observed in the clinic. However, there have been no reports thus far of lead poisoning caused by drugs that were approved by the Korea Food and Drug Administration (KFDA). Here, we describe seven patients who ingested a problematic natural product-derived drug (NPD). CASE PRESENTATION: In July 2018, seven patients visited a university hospital after ingesting an NPD, S. capsules. These patients complained of various symptoms, and their blood lead levels (BLLs) were elevated relative to those of the general population (arithmetic mean: 19.5 ± 11.6 µg/dL, range: 6.28–35.25 µg/dL). The total doses and BLLs were directly proportional to each other among the patients (r = 0.943, p = 0.001). After the patients discontinued drug intake, their BLLs decreased gradually. The capsule was confirmed to contain lead above the standard value (arithmetic mean: 2,547 ± 1,821.9 ppm). CONCLUSION: This incident highlights the need to strengthen standards for the management of NPD ingredients in Korea. NPDs are more likely to be contaminated than other drugs. Thorough management by the KFDA is essential to prevent a recurrence. Moreover, systematic health care is needed for many patients who have taken problematic NPDs.
Asian Continental Ancestry Group ; Capsules ; Delivery of Health Care ; Humans ; Korea ; Lead Poisoning ; Recurrence ; United States Food and Drug Administration

Scombroid fish poisoning (SFP) is a form of histamine food poisoning caused by the ingestion of improperly stored fish. The term “scombroid” derives from the family name of the fish family first implicated, such as tuna and mackerel. On the other hand, non-scombroid fish species, such as sardine and herring, can also cause histamine poisoning. The histamine is converted from histidine by a bacterial enzyme in the causative fish. Because the symptoms of SFP can easily be confused with food allergies, it is believed to have been significantly under-reported. In 2016, an outbreak of SFP occurred among primary school students who had eaten yellowtail steak in Korea. The most common findings consisted of a rapid onset of flushing of the face and trunk, erythematous and urticarial rash, diarrhea, and headache occurring soon after consuming the spoiled fish. Usually, the course is self-limiting and antihistamines can be used successfully to relieve symptoms, but several life-threatening SFP cases have been reported. Clinical toxicologists should be familiar with SFP and have competency to make a differential diagnosis between fish allergy and histamine poisoning. SFP is a histamine-induced reaction caused by the ingestion of histamine-contaminated fish, whereas a fish allergy is an IgE-mediated reaction. This review discusses the epidemiology, pathophysiology, diagnosis, treatment, and preventive measures of SFP.
Diagnosis ; Diagnosis, Differential ; Diarrhea ; Eating ; Epidemiology ; Exanthema ; Flushing ; Food Hypersensitivity ; Foodborne Diseases ; Hand ; Headache ; Histamine Antagonists ; Histamine ; Histidine ; Humans ; Hypersensitivity ; Korea ; Perciformes ; Poisoning ; Tuna

BACKGROUND: In November 2016, an outbreak of scombroid fish poisoning occurred among elementary school students in Seoul, Korea. An epidemiological investigation was conducted to identify the cause and source of the illness. METHODS: A case-control study was conducted among school members who had eaten lunch in the school. The histamine level in the suspect food item (yellowtail steak) was measured. RESULTS: Fifty-five (5.4%) of 1,017 school members who consumed fish for lunch fell ill. The principal symptoms were flushing (100%) and headache (72.7%); the median incubation period was 40 minutes. All had consumed yellowtail steak (odds ratio, 9.24; 95% confidence interval, 1.22–69.91). Leftover steak had an elevated histamine level (293 mg/kg), higher than the allowed 200 mg/kg. CONCLUSION: An outbreak of scombroid fish poisoning was confirmed; this is the first such report in Korea. Detailed food safety guidelines must be established.
Case-Control Studies ; Flushing ; Food Safety ; Foodborne Diseases ; Headache ; Histamine ; Humans ; Korea* ; Lunch ; Poisoning* ; Seoul*

Foodborne disease is one of the most important public health issues worldwide. China faces various and unprecedented challenges in all aspects of the food chain. Data from laboratory-based foodborne disease surveillance systems from 2013 to 2016, as well as different regions and ages, can be found along with differences in the patterns of pathogens detected with diverse characteristics. Vibrio parahaemolyticus has been the leading cause of infectious diarrhea in China, especially among adults in coastal regions. Salmonella has been a serious and widely distributed pathogen responsible for substantial socioeconomic burden. Shigella was mostly identified in Northwest China and the inland province (Henan) with less-developed regions among children under 5 years. Data from foodborne disease outbreak reporting system from 2011 to 2016 showed that poisonous animals and plant factors responsible for most deaths were poisonous mushrooms (54.7%) in remote districts in southwest regions. The biological hazard that caused most cases reported (42.3%) was attributed to V. parahaemolyticus, the leading cause of foodborne outbreaks. In this review, we summarize the recent monitoring approach to foodborne diseases in China and compare the results with those in developed countries.
Bacteria ; classification ; isolation & purification ; China ; epidemiology ; Disease Outbreaks ; Food Microbiology ; Foodborne Diseases ; epidemiology ; microbiology ; Forecasting ; Humans ; Laboratories ; Mushroom Poisoning ; epidemiology ; Population Surveillance ; Public Health

Disease Outbreaks ; Epidemics ; Foodborne Diseases ; Humans ; Salmonella Food Poisoning ; Salmonella enteritidis

OBJECTIVE: Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker. MATERIALS AND METHODS: A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications. RESULTS: Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient's medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours. CONCLUSIONS: Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.
Angiography ; Burns ; Carbon Monoxide Poisoning ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Cardiomyopathies* ; Charcoal* ; Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Death, Sudden ; Diagnosis ; Electrocardiography ; Emergency Service, Hospital ; Food Services ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; Occupational Health ; Occupational Health Services ; Reference Values ; Restaurants* ; Syncope

OBJECTIVE: To analyze the medical records of poisoned children to provide references for the forensic identification of melamine-tainted milk powder poisoning. METHODS: Medical records of six fatal cases of consuming some brand melamine-tainted milk powder were studied, specifically the poisoning symptoms, medical imaging, blood biochemical tests, treatment and prognosis. RESULTS: The major medical problems of these eight-month sick infants were urinary tract obstruction caused by urinary tract calculi. The poisoned infants developed oliguria, anuria and other symptoms, eventually, acute renal failure or other complications leaded to death. The serum BUN and Cr abnormally increased. CONCLUSION By considering the toxicological effects of melamine, it was concluded that the deaths of these sick infants were related to the melamine poisoning.
Acute Kidney Injury ; Animals ; Fatal Outcome ; Food Contamination ; Forensic Sciences ; Humans ; Infant ; Milk/chemistry* ; Prognosis ; Triazines/poisoning* ; Urinary Calculi

OBJECTIVES: A salmonellosis outbreak occurred within a community of Gyeongju residents who ingested catered food from a wedding in June 2009. We aimed to epidemiologically investigate the probable vehicle of the infection. METHODS: We conducted a retrospective cohort study on 34 local residents who ingested the wedding food. RESULTS: Among the 34 residents, 31 (91.2%) reported symptoms of infection after eating the food. Among all of the wedding foods, pan-fried foods were highly associated with the diarrheal attack rate. On bacteriological examination, Salmonella species were detected in the pan-fried foods among the leftover foods and in 17 of the 31 stool specimens from the cases. There were five different types of pan-fried foods, but the onset of symptoms was independent of the ingredients used. We found that the pan-fried food was prepared at a food store in Seoul and that eggs were a common ingredient. CONCLUSIONS: The major cause of the salmonellosis in this population was presumed to be the pan-fried food prepared with contaminated eggs. These food items might have been partially undercooked because of their irregular shape, which allowed the Salmonella species to survive and multiply before ingestion.
Cohort Studies ; *Disease Outbreaks ; Eggs/microbiology ; Feces/microbiology ; *Food Microbiology ; Fruit/microbiology ; Humans ; Republic of Korea/epidemiology ; Retrospective Studies ; Salmonella/*isolation & purification ; Salmonella Food Poisoning/*epidemiology ; Time Factors

Mushroom and fish bile toxins are the most representative toxins of food origin. According to the clinical manifestations, renal injury caused by mushroom toxins can be divided into early-, late-, and delayed-onset. Fish bile toxins mainly cause acute renal tubular necrosis and food contamination related to renal injury includes chemical and biological contamination. Urinary calculus and renal failure caused by "poisonous milk powder" is a typical, food-related chemical contamination event. E.coli contaminated cucumber caused hemolytic uremic syndrome in 3 493 people. Contamination of the food chain is spreading from land to sea and to sky. It requires the efforts of the whole society to prevent human food chain contamination.
Animals ; Bile ; Child ; Fishes ; Food Chain ; Food Contamination ; Humans ; Kidney Diseases ; etiology ; Mushroom Poisoning ; complications