On 13 November 2019, a public health unit in Sydney, Australia was notified of two unrelated patients who presented on the previous day to different emergency departments (EDs) with methaemoglobinaemia.1 Both had sudden symptom onset after dining at the same restaurant, raising suspicion that these presentations were linked to contaminated food, and prompting investigation. Foodborne illness in two or more related cases is notifiable under the Public Health Act 2010 (NSW).2
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- 1. NSW Health. Communicable Diseases Weekly Report. Week 46, 10 November to 19 November 2019. Sydney: NSW Health, 2019. https://www.health.nsw.gov.au/Infectious/Reports/Publications/cdwr/2019/cdwr‐week46‐2019.pdf (viewed July 2020).
- 2. NSW Government. Public Health Act 2010 No 127: Schedule 2 Notifiable diseases. https://www.legislation.nsw.gov.au/#/view/act/2010/127/sch2 (viewed July 2020).
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- 5. Hord NG, Tang Y, Bryan NS. Food sources of nitrates and nitrites: the physiologic context for potential health benefits. Am J Clin Nutr 2009; 90: 1–10.
- 6. Australia New Zealand Food Standards Code. Schedule 15 Substances that may be used as food additives. https://www.legislation.gov.au/Details/F2020C00203 (viewed July 2020).
- 7. Maric P, Ali SS, Heron LG, et al. Methaemoglobinaemia following ingestion of a commonly available food additive. Med J Aust 2008; 188: 156–157. https://www.mja.com.au/journal/2008/188/3/methaemoglobinaemia‐following‐ingestion‐commonly‐available‐food‐additive
We thank Keira Glasgow, Manager of Enteric and Zoonotic Diseases with the Enterics, Zoonoses and Multi‐Resistant Organisms Branch at NSW Health, for her input during the investigation.
No relevant disclosures.