Characterization of an Unusual Foodborne Illness Including an Outbreak and Sporadic Illness Caused by Three Bacterial Pathogens Via a Takeaway Service

Takeaway food services are an emerging business in China and have a potential impact on food safety. An unusual foodborne illness associated with takeaway food delivered through a logistics company on August 27, 2018 is reported. Epidemiological investigations showed that 28 patients from 2 companies were diagnosed with gastroenteritis symptoms. The major symptoms included nausea (24, 85.71%), vomiting (24, 85.71%), diarrhea (22, 78.57%), and abdominal pain (22, 78.75%). Laboratory investigations showed that six Staphylococcus aureus isolates, three Salmonella enteria serovar livingstone isolates, and one Vibrio parahaemolyticus isolate were detected. Six S. aureus isolates were detected from one patient, food, and a food handler, and all six S. aureus isolates had the same pulsed-field gel electrophoresis (PFGE) pattern and multilocus sequence typing (MLST) genotype. Staphylococcal enterotoxin A was detected from food and the six S. aureus isolates. These results confirmed that S. aureus isolates were the major agent causing this foodborne illness. Three Salmonella isolates with the same PFGE pattern and MLST genotype were detected from patients. This was the first time that Salmonella isolates have been identified as causing a foodborne disease outbreak in China. Only one O4:K8 serotype of V. parahaemolyticus with the tdh gene isolate was detected from one patient. These results confirmed that this was an unusual foodborne illness that included an outbreak associated with two different pathogens and a third pathogen sporadic illness. Takeaway services pose a risk to public health because they have the potential to distribute contaminated products over a large geographic area within a short time. Therefore, more attention should be paid to prevent and control foodborne illnesses caused by contaminated food from takeaway services.