Foodborne outbreak of enterotoxigenic Staphylococcus aureus at a school in Hebei, China.

In 2024, a S. aureus foodborne illness outbreak in Hebei Province, China, affected 61 out of 563 individuals (10.84 % prevalence), causing symptoms like diarrhea, vomiting, abdominal pain, and nausea. A case-control study implicated ròujiámó, a breakfast item, as the suspected vehicle (OR = 34.81, 95 % CI: 2.07-585.30, P < 0.001). Laboratory analyses identified S. aureus in samples collected from patients, kitchen workers, food, and the environment. Three strains, belonging to ST6 and spa type t701, were isolated and characterized. They showed resistance to penicillin, harbored many virulence genes including sea, and clustered closely in phylogenetic analysis. Notably, the sea gene was located on an intact prophage element that may enhance its pathogenic potential and pose new clinical challenges. The outbreak was due to S. aureus contamination in ròujiámó caused by unsafe kitchen practices. Improved food safety supervision and worker education are needed to prevent future outbreaks.