Foodborne disease — The emetic (vomiting) type of food poisoning caused by Bacillus cereus is most commonly linked to which food item when improperly handled?

Introduction / Context:
Bacillus cereus causes two distinct foodborne syndromes: emetic (rapid-onset vomiting) and diarrheal (later-onset diarrhea). Recognizing the typical food vehicle for the emetic type helps in epidemiology, prevention, and rapid source identification during outbreaks.

Given Data / Assumptions:

• B. cereus forms heat-resistant spores that can survive cooking.
• Starchy foods that are cooked and then held warm or improperly refrigerated favor toxin production.
• The emetic syndrome is linked to a preformed, heat-stable toxin.

Concept / Approach:
Fried rice or reheated boiled rice is the classic vehicle for the emetic type. After cooking, if rice is left at room temperature or in the danger zone, spores germinate and the emetic toxin (cereulide) accumulates. Reheating does not inactivate the toxin, leading to rapid-onset vomiting (often within 1–5 hours). Meat, milk, and eggs can be involved in other foodborne illnesses, but rice is most strongly associated with the emetic B. cereus syndrome.

Step-by-Step Solution:

Verification / Alternative check:
Outbreak investigations repeatedly link emetic B. cereus to fried rice dishes in restaurants and catering events, supporting this association.

Why Other Options Are Wrong:

• Meat/Milk/Eggs: Less commonly tied to emetic B. cereus; may relate to other pathogens or the diarrheal B. cereus syndrome.

Common Pitfalls:
Assuming all B. cereus cases are diarrheal; the emetic type is distinct and linked to starchy foods, especially rice.

Final Answer:
Rice