Name two foodborne toxins produced by Bacillus cereus and Staphylococcus aureus that cause vomiting, and indicate their general time to onset.

• A. Cereulide toxin from Bacillus cereus (emetic toxin) with rapid onset (1-5 hours); Staphylococcus aureus preformed enterotoxins (rapid onset, 1-6 hours).
• B. Shiga toxin; Enterotoxin B.
• C. Aflatoxin; Botulinum toxin.
• D. Diphtheria toxin; Tetrodotoxin.

Answer: (A)

Vomiting in foodborne illness from these bacteria comes from toxins that are already present in food before ingestion. The best pair here is cereulide, the emetic toxin produced by Bacillus cereus, and the preformed enterotoxins produced by Staphylococcus aureus. Cereulide is heat-stable, so it can survive cooking, and when ingested it typically triggers vomiting within about 1 to 5 hours. Staphylococcus aureus can form enterotoxins that are also heat-stable and preformed in foods like dairy products, mayonnaise-based salads, and meats; ingestion leads to rapid vomiting usually within 1 to 6 hours. These two toxins are the classic culprits for quick-onset vomiting tied to these two organisms. The other toxin pairs involve different organisms or clinical pictures (diarrheal syndromes, neurotoxic effects, etc.), so they don’t fit this vomiting-and-rapid-onset pattern.