Table 1.

The two types of food poisoning caused by Bacillus cereus.

	Diarrhoeal syndrome	Emetic syndrome
Toxins	Nonhaemolytic enterotoxin (Nhe) Haemolysin BL (Hbl) Cytotoxin K (CytK)	Cereulide (Ces)
Dose necessary for illness	≥ 105 cfu g−1 of food a	~400 μg cereulide b
Requirements for illness	Growth in food to an infectious dose, consumption of which leads to infection and formation of toxins in small intestine of host	Cereulide production in food at high cell concentration. Illness caused by ingestion of food containing pre-formed toxin (intoxication)
Incubation time	8–24 h	0.5–5 h
Duration of illness	12–24 h	6–24 h
Toxin produced	Small intestine of host	Pre-formed in foods
Toxin properties	Heat labile proteins (inactivated by 56 °C/5 min) Inactivated by proteases and pH < 4.0	Heat stable cyclic peptide (no loss of activity at 121 °C for 90 min) Not inactivated by protease enzymes Stable at pH 2 to 11
Foods implicated	Meat products, fish, poultry, soups, sauces and stews, milk products and vegetables	Farinaceous foods such as rice, pasta, noodles, potatoes, bread and pastries

Adapted from Ceuppens et al. (2011), Ceuppens et al. (2013), Stenfors Arnesen et al. (2008).

^aconcentration unacceptable for ready-to-eat foods (EFSA, 2016; Health Protection Agency, 2009).

^bquantity of cereulide necessary to cause illness to a 50 kg human assuming 8 μg cereulide kg⁻¹ is the toxic dose for humans (Jääskeläinen et al., 2003).