Poisonous mushrooms remain a major problem in China as they caused the most outbreaks and deaths in the country in this past year. In 2020, there was a total of 7,073 foodborne outbreaks reported, resulting in 37,454 illnesses and 143 deaths.

The study published in the journal China CDC Weekly used data on cases reported through the National Foodborne Disease Outbreaks Surveillance System from January to December 2020.

Poisonous mushrooms were the top cause of deaths in private homes. Residents in mountainous areas of southwest and central China tended to pick mushrooms and poisonous plants frequently in the wild.

Researchers said publicity should be increased to reduce the incidence of mushroom intoxications in families. People picking and eating mushrooms could not distinguish between poisonous and non-toxic ones, and the rate of timely treatment after poisoning was low and increased the risk of death.

Overall, most outbreaks, illnesses, and deaths were linked to home cooking and catering services. Home cooking had the most deaths with 128.

Influenced by the COVID-19 pandemic, for the first time in the past five years, outbreaks that occurred in private homes surpassed those in catering service units in 2020, according to the report.

Place of infection
This past year, the majority of outbreaks occurred in households with 4,140, followed by catering services with 2,719, and 27 at school campuses. Most illnesses were reported in catering locations, followed by households and only a few in campuses.

Within catering service sites, street stalls accounted for the largest proportion of outbreaks, and school canteens for the most illnesses. More than 100 outbreaks with 1,807 patients were because of home delivery of the meal.

Poisonous mushrooms were behind 80 deaths, aconite, a plant that contains poisonous chemicals, was responsible for 12 deaths, bongkrek acid for 12, and methanol for 14.

Outbreaks occurring between June and September made up almost two thirds of the total.

For 4,662 confirmed incidents, poisonous mushrooms were the most common cause of outbreaks and deaths while bacterial pathogens were the main cause of illnesses.

Agents responsible for illness
Salmonella with 286 outbreaks and 3,446 illnesses was the top bacterial pathogen linked to outbreaks and illnesses, followed by Vibrio parahaemolyticus at 128 outbreaks and 1,848 illnesses, and Staphylococcus aureus with 75 outbreaks and 954 illnesses.

More than 1,500 people were sick in 54 E. coli outbreaks and 620 illnesses came from 50 Bacillus Cereus outbreaks. Five Clostridium Perfringens outbreaks sickened 287 people, three Campylobacter jejuni outbreaks affected 133 while three Clostridium botulinum reports included 10 people. Only one Listeria monocytogenes outbreak was recorded with 28 patients.

Among the chemical agents, nitrite was the most common factor associated with outbreaks and illnesses, followed by pesticides. Plant and animal toxicants caused more than 1,000 outbreaks with 4,584 sick.

Findings provide a basis for prevention and control measures and support food safety risk assessment, formulation and revision of standards, and risk management, said researchers.

The top 10 pathogen-food category pairs resulting in outbreaks, illnesses, and deaths were analyzed. Salmonella in eggs was top followed by Salmonella in sauce-marinated meat and in pastry. Fourth was Bacillus cereus in rice flour and then Vibrio Parahaemolyticus in sauce-marinated meat.

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