A case study of a massive staphylococcal food poisoning incident.

In the summer of 1998, approximately 8000 individuals gathered to celebrate a Catholic priest's ordination in Minas Gerais, Brazil. Within hours of food consumption, 4000 patients experienced acute gastroenteritis, and approximately 2000 (50%) overwhelmed Emergency Departments of 26 local hospitals. Of the triaged patients, 396 ( approximately 20%) required subsequent admission, and of these patients, 81 ( approximately 20%) were admitted to intensive care units. A total of 16 ( approximately 20% of those admitted to the ICU) patients progressed on to develop irreversible multi-system shock and expired while hospitalized. The trace-back investigation implicated food preparers who were culture positive for enterotoxigenic Staphylococcus aureus as the source of contamination. This study provides information on the magnitude and severity of oral exposure to Staphylococcal enterotoxin.