I was very concerned about this too when I started making SMBC (I do not like American buttercream). Since I didn’t want to make my family & friends sick from one of my cakes, I researched & researched before I started using it. I do heat my egg whites to 150-160F. I also keep my cakes refrigerated until the time I deliver it to the family party. This way it is sitting out just long enough to bring it to room temperature. I’ve never had an issue but it is always in the back of my mind to be honest with you. I have never made IBC but want to try it one of these days.