Two hours after a birthday party where custard and cream pastries were served, several children develop sudden severe vomiting with mild diarrhoea. No fever is present and all recover within 24 hours. The most likely cause is an enterotoxin that is notable for being:

• A Heat-labile and destroyed by boiling for 10 minutes
• B Heat-stable and able to withstand boiling for 30 minutes ✓
• C Inactivated by gastric acid, requiring parenteral absorption
• D Produced only after sporulation in the host intestine

Explanation

Staphylococcus aureus enterotoxins are remarkably heat stable, resisting boiling for up to 30 minutes, so reheating contaminated food does not prevent disease. They act on the vagus nerve and the vomiting centre, producing emesis within 1 to 6 hours of eating foods such as custards, creams and processed meats handled by an infected carrier. Heat-labile toxins describe cholera-like or C. perfringens toxins, and staphylococcal enterotoxin is preformed in the food, not made in the gut.

Reference: Ananthanarayan and Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.