Epidemiological characteristics of foodborne disease outbreaks in schools in Hainan Province from 2014 to 2023

ObjectiveTo describe the epidemiological characteristics of school foodborne disease outbreaks in Hainan Province， China， from 2014 to 2023， and to provide evidence for targeted prevention and control strategies.MethodsData on 92 school foodborne disease outbreaks reported in Hainan Province during 2014—2023 were retrieved from the National Foodborne Disease Outbreak Surveillance System and analyzed using descriptive epidemiological analysis.ResultsA total of 92 outbreaks were reported， involving 1 082 cases （no deaths） among 33 010 exposed individuals. Outbreaks occurred in all months except July， with a peak in September （27.17%）. The highest number of outbreaks was reported in Haikou （26）， followed by Danzhou （17） and Sanya （8）. Most occurred in primary and secondary schools （68.48%）. Microbial agents were the predominant etiology （43.48%）， mainly Staphylococcus aureus and its enterotoxins （13 outbreaks）， Vibrio parahaemolyticus （8 outbreaks）， and Salmonella spp. （4 outbreaks）. Cross-contamination （16.30%） was the leading contributing factor， followed by contamination of raw materials （13.04%） and improper food processing （11.96%）. School canteens were the most frequently implicated setting （70.65%）. Accidental ingestion of toxic plants accounted for 5.43% of outbreaks and 13.49% of cases.ConclusionSchool foodborne disease outbreaks in Hainan Province were predominantly caused by microbial contamination linked to inadequate food-handling practices in canteens， highlighting the urgent need for strengthened food safety management and targeted training for food-handling personnel to reduce outbreak risks