Staphylococcal Food Poisoning Associated with Spray-Dried Milk

Summary Eight explosive outbreaks of food poisoning, occurring in school canteens in England during 1953 and affecting 1190 known cases, are described. The clinical features were characteristic of the toxin type of illness. No deaths occurred. The food causing all of these outbreaks was prepared from spray-dried skim milk powder. It was not subsequently heat-treated and was usually consumed 3–4 hr. after preparation. The spray-dried milk powder proved to contain a high content of bacteria, including large numbers ofStaph. aureus, of a phage pattern often associated with food poisoning. The assumption was therefore made that these outbreaks were caused by staphylococcal enterotoxin. Because the food was often consumed within 3–4 hr. of reconstitution of the milk powder—before, in fact, the staphylococci had had time to grow—it is concluded that the poisoning must have been due mainly to pre-formed toxin. Consideration is given to the opportunities for the formation of toxin in a spray-drying plant, and reasons are brought forward for believing that it is formed mainly in the balance tank where the warm milk is kept, sometimes for several hours, before passing into the final drying chamber. The processing of the milk and the precautions for preventing contamination of the finished product are discussed.