We describe the investigations and management of a Cryptosporidium parvum outbreak of linked to consumption of pasteurised milk from a vending machine. Multiple locus variable number of tandem repeats analysis was newly used, confirming that C. parvum detected in human cases was indistinguishable from that in a calf on the farm. This strengthened the evidence for milk from an on-farm vending machine as the source of the outbreak because of post-pasteurisation contamination. Bacteriological indicators of post-pasteurisation contamination persisted after the initial hygiene improvement notice. We propose that on-farm milk vending machines may represent an emerging public health risk.

On 26 November 2010, an outbreak of scombroid fish poisoning occurred in the French Armed Forces in Dakar, Senegal. This chemical intoxication, due to high histamine concentration in fish, is often mistaken for an allergic reaction. A case-control study was undertaken including the 71 cases and 78 randomly selected controls among lunch attendees. The usual symptoms for scombroid fish poisoning were observed in cases, i.e. flushing (85·9%), headache (83·1%), rapid/weak pulse (59·1%) and diarrhoea (47·9%). Symptoms occurred from within a few minutes to up to 3 h following the meal. Most patients quickly recovered with antihistamine and/or symptomatic treatment. Tuna was the only food item positively associated with illness (odds ratio 36·3, 95% confidence interval 6·3–210·0), with the risk of illness increasing with the quantity of fish consumed. No bacterial contamination was found in leftover food, but histamine concentration in tuna was found to be 4900 mg/kg, almost 50-fold higher than the concentration allowed by European regulations. This report is unique because of the large size of the case series – to our knowledge, the largest event of scombroid fish poisoning ever reported – and the chemical and bacteriological analyses results obtained on leftover food.

A population-based telephone survey of acute gastroenteritis (AG) was conducted in Hong Kong from August 2006 to July 2007. Study subjects were recruited through random digit-dialling with recruitments evenly distributed weekly over the 1-year period. In total, 3743 completed questionnaires were obtained. An AG episode is defined as diarrhoea ⩾3 times or any vomiting in a 24-h period during the 4 weeks prior to interview, in the absence of known non-infectious causes. The prevalence of AG reporting was 7%. An overall rate of 0·91 (95% CI 0·81–1·01) episodes per person-year was observed with women having a slightly higher rate (0·94, 95% CI 0·79–1·08) than men (0·88, 95% CI 0·73–1·04). The mean duration of illness was 3·6 days (s.d.=5·52). Thirty-nine percent consulted a physician, 1·9% submitted a stool sample for testing, and 2·6% were admitted to hospital. Of the subjects aged ⩾15 years, significantly more of those with AG reported eating raw oysters (OR 2·4, 95% CI 1·3–4·4), buffet meals (OR 1·8, 95% CI 1·3–2·5), and partially cooked beef (OR 1·8, 95% CI 1·2–2·7) in the previous 4 weeks compared to the subjects who did not report AG. AG subjects were also more likely to have had hot pot, salad, partially cooked or raw egg or fish, sushi, sashimi, and ‘snacks bought at roadside’ in the previous 4 weeks. This first population-based study on the disease burden of AG in Asia showed that the prevalence of AG in Hong Kong is comparable to that experienced in the West. The study also revealed some ‘risky’ eating practices that are more prevalent in those affected with AG.