Microbial Foodborne Poisoning-Related Deaths: A 10-Year Retrospective Autopsy-Based Study

Year 2025, Volume: 15 Issue: EK-1, 25 - 31, 20.10.2025

Mehmet Doğan , Adem Karbuz , İbrahim Üzün

Abstract

Aim: This study aims to evaluate foodborne death cases from a forensic medical perspective and to conduct a retrospective analysis based on autopsy findings.
Material and Method: A total of 36 cases reported to the Council of Forensic Medicine between 2014 and 2024, in which the cause of death was determined to be foodborne illness, were included. Sociodemographic data, clinical history, autopsy findings, microbiological analyses, and toxicological reports were reviewed. Statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) program with the Chi-square test used for categorical data comparisons (p<0.05 considered statistically significant).
Results: Most deaths occurred in summer months and following the consumption of poultry, particularly chicken. In 58.3% of cases, no microbiological analysis of food samples was conducted. Among the analyzed samples, the most frequently detected pathogens were Staphylococcus aureus, Salmonella spp., and Bacillus cereus. Significant associations were found between hospital admission and histopathological enteritis (p=0.031), presence of food analysis in mass poisoning events (p=0.022), and consistency of pathogens with Ministry of Agriculture reports (p=0.0005).
Conclusion: The findings highlight the importance of ensuring food safety, conducting comprehensive forensic autopsies, and enhancing inter-institutional coordination to protect public health.

Keywords

foodborne diseases , forensic autopsy , microbiological analysis , bacillus cereus; public health

References

• 1. AL-Mamun M, Chowdhury T, Biswas B, Absar N. Food Poisoning and Intoxication: A Global Leading Concern for Human Health. Elsevier Inc.; 2018.
• 2. https://www.who.int/data/gho/data/themes/who-estimatesof-the-global-burden-of-foodborne-diseases Accessed date: 22.03.2025. https://www.who.int/data/gho/data/themes/ who-estimates-of-the-global-burden-of-foodborne-diseases
• 3. Öz V, Karadayi Ş, Çakan H, Karadayi B, Kaya A. Acil tedavi birimlerinde gıda zehirlenmeleri. Marmara Med J. 2014;27(2):89–95.
• 4. Mead PS, Slutsker L, Dietz V, et al. Food-related illness and death in the United States. J Environ Health. 2000;62(7):9–18.
• 5. Byard RW. Death by food. Forensic Sci Med Pathol. 2018;14(3):395–401.
• 6. Devers KG, Nine JS. Autopsy findings in botulinum toxin poisoning. J Forensic Sci. 2010;55(6):1649–1651.
• 7. Takabe F, Oya M. An autopsy case of food poisoning associated with Bacillus cereus. Forensic Sci. 1976;7(2):97–101.
• 8. Schreiber N, Hackl G, Reisinger AC, et al. Acute liver failure after ingestion of fried rice balls: A case series of bacillus cereus food poisonings. Toxins (Basel). 2022;14(1):1–11.
• 9. Naranjo M, Denayer S, Botteldoorn N, et al. Sudden death of a young adult associated with Bacillus cereus food poisoning. J Clin Microbiol. 2011;49(12):4379–4381.
• 10. https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=5237&Me vzuatTur=1&MevzuatTertip=5 Accessed date: 22.03.2025.
• 11. Schoeni JL, Lee Wong AC. Bacillus cereus food poisoning and its toxins. J Food Prot. 2005;68(3):636–648.
• 12. Demirözü B. Türkiye ve Dünyada Gıda Denetimi ve Laboratuvarlar. Gıda Mühendisliği Derg. 2004:19–25.
• 13. Özgel Ö. Mersin ilinde bulunan hazır yemek firmalarının mutfak hijyeni koşullarının değerlendirilmesi. 2019.
• 14. Kattamreddy AR, Ganja CD, Ramudu GJ. Autopsy in a Suspected Case of Food Poisoning - Approach and Challenges. J Indian Acad Forensic Med. 2022;44(4):94–96.
• 15. Başaran B. A Study of Food Poisoning Cases in Turkey from 2016 to 2020 According to the Written and Visual Media. Akad Gida. 2021;19(3):281–290.
• 16. Urazel B. The evaluation of forensic cases reported due to food poisoning. Dicle Med Journal/Dicle Tıp Derg. 2014;41(1):113–117.
• 17. Kumagai Y, Pires SM, Kubota K, Asakura H. Attributing Human Foodborne Diseases to Food Sources and Water in Japan Using Analysis of Outbreak Surveillance Data. J Food Prot. 2020;83(12):2087–2094.
• 18. Tong JL, Engle HM, Cullyford JS, Shimp DJ, Love CE. Investigation of an outbreak of food poisoning traced to turkey meat. Am J Public Health. 1962;52(6):976–990.
• 19. Heredia N, García S. Animals as sources of food-borne pathogens: A review. Anim Nutr (Zhongguo xu mu shou yi xue hui). 2018;4(3):250–255.
• 20. WHO. Five Keys to Safer Food Manual. Five Keys to Safer Food Man. 2006:1–30. http://www.who.int/foodsafety/ publications/consumer/manual_keys.pdf
• 21. Argaw S, Addis M. A Review on Staphylococcal Food Poisoning (Tinjauan tentang Keracunan Makanan Stafilokokus). 2015;40:59–72. www.iiste.org
• 22. Gallo M, Ferrara L, Calogero A, Montesano D, Naviglio D. Relationships between food and diseases: What to know to ensure food safety. Food Res Int. 2020;137(January) :109414.
• 23. Surawicz CM, Haggitt RC, Husseman M, McFarland L V. Mucosal biopsy diagnosis of colitis: acute self-limited colitis and idiopathic inflammatory bowel disease. Gastroenterology. 1994;107(3):755–763.
• 24. Afoakwah NA, Mahunu GK, Osae R, Pereko K. Food Intoxication: Prevention, Diagnoses, and Treatment. Microb Toxins Food Syst Causes, Mech Complicat Metab. 2024:153165.