Large-Scale Staphylococcus aureus Foodborne Disease Poisoning Outbreak among Primary School Children
, Paal Skytt Andersen 2,4, Huong Minh Nguyen 5, Yen Thi Ta 1 and Trung Thanh Nguyen 1,*Round 1
Reviewer 1 Report
The authors present a well-described paper of a large-scale food poisoning outbreak due to S. aureus cross-contamination and enterotoxins production. The case is well described.
There are some mistakes to be fixed:
Line 20: "S. aureus strains isolated from all sample were identical": the statement is very strong, are you sure that are identical or are closed related. The authors should correct that.
Lines 111, 117,118: add the ISO numbers
Charter 2.4. Microbiological analysis and characterization of S. aureus: add more details regarding the PCR protocol or specify that are exactly the same as that were reported in the reference, it is not clear
Line 126: is not clear what 0.211 ng/g stands for, is the Limit of Detection? Limit of Quantification? The TECRA kit is a quantitative kit? Please specify.
Line 181: how did the authors test the enterotoxin activity of vomit? Which protocol has used for testing this matrix? Please specify. The same consideration is valid for the strains isolated (line 182): you had tested the BHI broth pure culture? Please specify.
Line 268-270: missing reference of the three cases in Europe. Please add in the text and in Reference session.
Fig. 1: are the authors sure that is necessary and not ambiguous? I think you can delete and only discuss the results of the eBURST analysis.
Author Response
Please see the attachment.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Manuscript ID: microbiolres-1071220
Title: Large-scale Staphylococcus aureus foodborne disease poisoning outbreak among primary school children.
Summary: This is a concise and well-written brief report covering the important aspect and challenge of under-reporting of foodborne diseases in general and S. aureus outbreaks in particular. Even though this is not ground-breaking new findings or research, a monitoring and surveillance study serves the important role of building up knowledge and track records for the future. This will be of great support to continually expand the knowledge regarding food safety, increase awareness and improve hygiene and handling conditions along the entire food supply chain (as the authors states very well on lines 301-303).
Below are some minor comments and suggestions to improve the clarity of the manuscript further.
Minor comments:
L 33-34. Please explain the phrase ”…and strong survival on fomites which allow them to…..unable to endure high temperatures, …”
L 81. Please clarify: do the authors refer to staphylococcal intoxication (food poisoning) or S. aureus infection (not related to food poisoning – why would this be relevant in the context of this study)?
L 111, 117 and 118. Please, specify the specific ISO methods used for each analysis.
L 163. Remove space between 352/ and 926 in the brackets.
L 177. What does (6) refer to after “hospital”?
L 184 and 185. Suggestions: write 20 out of 21 instead of using /.
L 186. When (in time) was the swabbing of the hands performed on the kitchen workers in relation to the discovery of the outbreak?
Figure 1. Elaborate the figure legend. It is very limited as it is written now.
L 232-233. Was there any continuous/follow-up investigation in the abattoir in order to find the source/route cause for the contamination?
L 239 in combination with L 273-274. Were the handling routines of raw material vs cooked food scrutinized in the school (to avoid cross contamination in the future)? When were conditions provided that allowed for staphylococcal enterotoxins to be formed (contaminated food kept for longer periods in ambient temperatures)?
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
