Global Epidemiology and health risks of Bacillus cereus Infections: Special focus on infant foods

Abstract

Bacillus cereus is a common pathogen responsible for gastrointestinal and other complicated disorders, yet epidemiological data and public health measures remain scarce. To bridge these gaps, a bilingual search spaning 50 years identified 266 relevant studies on global B. cereus infection, encompassing 6,135 cases. The global mortality rate for B. cereus infection is 0.9 %. Food poisoning cases account for 94.31 % (5786/6135) of the total infections, with a mortality rate of 0.05 %. B. cereus infections were primarily reported in East Asia, Europe, and North America, with frequent studies in eastern and southern China. Rice was recognized as the highest-risk food category for B. cereus-associated food poisoning, with 43 reported incidents. Younger populations, particularly infants and toddlers (<2 years) and school-age children (6–18 years), tend to exhibit more severe symptoms. These symptoms include fulminant liver failure, rhabdomyolysis, and metabolic acidosis. The outcomes of severe cases are associated with specific toxin types, with cereulide-producing strains linked to complicated clinical disorders and outcomes. These findings highlight the need for targeted epidemiological surveillance and public health interventions to mitigate B. cereus-associated infections.