Epidemiology of foodborne bongkrekic acid poisoning outbreaks in China, 2010 to 2020

Foodborne bongkrekic acid (BA) poisoning is a fatal foodborne disease in China. From 2010–2020, a total of 19 BA poisoning outbreaks were reported to the China National Foodborne Disease Outbreak Surveillance System. These outbreaks involved 146 illnesses, 139 hospitalizations, and 43 deaths, with a case-fatality rate of 29.5%. Approximately 73.3% of the outbreaks occurred in South and Southwest China. Homemade fermented corn flour products, tremella, and sweet potato flour and corn flour products (jelly) caused more early outbreaks, and novel vehicles (wet rice noodles and Auricularia auricula) were associated with later outbreaks in the study period. Outbreaks most frequently occurred at home (79.0%) and in restaurants (21.0%). The prohibition of traditional processed homemade fermented corn flour products and improvement in bongkrekic acid poisoning case identification and early treatment have resulted in a reduction in the case-fatality rate.