The Microworld.

The Microworld

Foodborne Diseases Intoxication – Ingestion of toxins present in the food Toxins formed and secreted by microorganisms during growth in food & make you sick Toxico-infection – Bacteria grow in food, no toxins produced Pathogenic bacteria enter the body Toxins produced during growth in intestinal tract and you get sick Infection - Pathogenic bacteria enter body and invade cells of intestinal mucosa Multiplication within mucosal cells or spreading to other organs Just bacteria makes you sick

Definitions Foodborne illness – Illness carried or transmitted to people by food. Foodborne Infections – result of a person eating food containing pathogens, which then grow in the intestines and cause illness. ( typically symptoms of foodborne illness do not appear immediately) Foodborne infection – Just the bacteria make you sick

Definitions Foodborne intoxication
Result of a person eating food containing toxins (poisons) that cause an illness. The toxins my have been produced by pathogens found on the food or may be result of a chemical contamination, or part of the natural food. Appear quickly, within a few hours.

Definitions Foodborne Toxin-mediated (Toxicoinfection) infection
Result of a person eating food containing pathogens which then produce illness-causing toxins in the intestines. Gastrointestinal illness Illness relating to the stomach or intestine

Campylobacter jejuni Foodborne Infection Microaerophilic
Curved Rod shape #1 cause of bacterial foodborne illness in U.S. Est. 2-4 million cases a year Guillian Barré Syndrome Neuromuscular disease

Campylobacter jejuni Common Foods Prevention Measures Poultry
Contaminated Water Prevention Measures Cook Food particularly poultry, to required minimum internal temperatures Prevent Cross-contamination between raw and ready-to-eat food.

Salmonella spp. Illness: Salmonlellosis 2,300 serovars
Rod shaped, Non-spore forming Facultative Anaerobe Asymptomatic carrier Carry pathogenic organism without symptoms “typhoid mary” – Mary Malone 53 people, 7 outbreaks, 3 deaths A serovar or serotype is a group of microorganisms or viruses based on the cell surface antigens. Serovars allow organisms to be classified at the sub-species level; an issue of particular importance in epidemiology All regarded as human pathogens Facultative Anaerobe – Able to grow in both the presence and absence of oxygen “typhoid mary” – Mary Malone ( ) Salmonella typhi US typhoid carrier. Working as a private cook while carrying the bacteria that cause typhoid fever, she infected wealthy New York families with the disease Never ill herself, she was finally tracked down and hospitalized in New York City to protect others. Discovered cooking again for a New Jersey sanatorium in 1914, she was hospitalized for life. It is estimated that Mallon passed the disease on to at least 50 people, three of whom died.

Classification based on Disease Syndrome
Typhoid fever Paratyphoid fever Salmonellosis (Gastroenteritis) Typhoid fever (or enteric fever) is an illness caused by the bacterium Salmonella Typhi. Common worldwide, it is transmitted by ingestion of food or water contaminated with feces from an infected person.[1] The bacteria then multiply in the blood stream of the infected person and are absorbed into the digestive tract and eliminated with the waste. Typhoid fever is characterized by a slowly progressive fever as high as 40 °C (104 °F), profuse sweating and gastroenteritis. Less commonly, a rash of flat, rose-colored spots may appear Paratyphoid fever is an illness caused by the bacterium Salmonella Paratyphi. The paratyphoid bears similarities with typhoid fever, but its course is more benign Gastroenteritis involves diarrhoea or vomiting, with noninflammatory infection of the upper small bowel, or inflammatory infection of the colon, both part of the gastrointestinal tract.

Salmonella typhi Habitat: GI tract of humans, polluted H2O Vaccine
Poor Sanitation Not common in U.S. Infectious dose – 1-10 cells Typhoid fever (Typhoid fever – once you have it cant get it again) high fever – 105° F Severe Diarrhea Vomiting Dehydration Cartiovascular collapse Death circulatory collapse is defined as a general or specific failure of the circulation, either cardiac or peripheral in nature. A common cause of this could be shock[1] or trauma from injury or surgery Cardiac circulatory collapse affects the vessels of the heart such as the aorta and is almost always fatal. It is sometimes referred to as "acute" circulatory failure.

Salmonella paratyphi Habitat: GI tract of humans, Polluted H2O
Similar to typhoid fever but not as severe Disease : paratyphiod fever

Salmonellosis/Gastroenteritis
Foodborne Infection Severity depends on health, age, # cells Onset: 6 – 72 hrs Duration: 2-3 days Symptoms Nausea, Vomiting, Diarrhea Headache, Fever, Chills Sweating, Weakness Severity depends on health, age, # cells injested 4.1% mortality rate mostly elderly

Salmonellosis/Gastroenteritis
Carriers/Implicated foods Poultry – meat and eggs Cattle – beef and dairy prod. Swine – pork RTE foods Other implicated foods Wildgame Orange juice Alfalfa sprouts Nuts – Snickers Cantaloupes/Melons

Control of Salmonella Personal hygiene – Hand washing
Cooking/Pasteurization Poultry 165°F for 15 sec. Eggs Raw or undercooked or minimally cooked eggs – pasteurized egg product Keep adequately refrigerated will prevent any Salmonella present in the eggs from growing to higher numbers Avoid Cross Contamination Reduce your risk of Salmonella: Keep eggs refrigerated. Discard cracked or dirty eggs. Wash hands and cooking utensils with soap and water after contact with raw eggs. Eat eggs promptly after cooking. Do not keep eggs warm for more than two hours. Refrigerate unused or leftover egg-containing foods. Avoid eating raw eggs (as in homemade ice cream or eggnog). Commercially manufactured ice cream and eggnog are made with pasteurized eggs and have not been linked with Salmonella enteritidis infections. Avoid restaurant dishes made with raw or undercooked, unpasteurized eggs. Restaurants should use pasteurized eggs in any recipe (such as Hollandaise sauce or caesar salad dressing) that calls for pooling of raw eggs.

Shigella spp. Rod Shaped Habitat – GI tract of humans
Small infective dose – 10 cells Easily transmissible because of low infectious dose Foodborne infection Disease: Shigellosis or Bacilliary dysentary The authors use "spp." as a short way of saying that something applies to many species within a genus, but do not wish to say that it applies to all species within that genus. If scientists mean that something applies to all species within a genus, they use the genus name without the specific epithet.

Shigellosis Disease of Armys, Asylums, and Prisons Symptoms
Concentrated people Dorms, school systems, military Symptoms Nausea, Vomiting Abdominal Pain Diarrhea (watery/bloody) Fever/Chills Prostration, Fatigue Sever cases - HUS prostration - a condition marked by dizziness and nausea and weakness caused by depletion of body fluids and electrolytes "HUS" hemolytic uremic syndrome is a predominantly pediatric condition is a disease characterised by microangiopathic hemolytic anemia, acute renal failure and a low platelet count microangiopathic hemolytic anemia (MAHA) is a subgroup of hemolytic anemia (anemia, loss of red blood cells through destruction

Shigellosis Onset: 1-3 days Duration: 4 days or more
Most often , BUT Not always self limiting Sometimes must use antibiotics Transmited via fecal-oral route Food Infection self-limiting organism or colony of organisms limits its own growth by its actions

Shigellosis Implicated Foods Control Heavily Handled Foods
Salads/Lettuce Ready to Eat Meat products Control Personal Hygeine – Hand Washing Exclude infected foodhandlers Control flies inside and outside the establishment

Listeria monocytogenes
Rod Non-spore forming Psychrophile Anaerobic Habitat: Decaying vegetative mater Soil GI tract of animals and humans Cool, wet, damp processing environments Psychrophile capable of growth and reproduction in cold temperatures Can grow at 1 degree Celsius(33.8 degrees Fahrenheit)

Disease: Listeriosis Onset: 3 to 70 days Occurs most frequently in at risk populations Opportunistic Pathogen Prevention: Watch sell-by date Prevent cross-contamination Cook meat to proper temperature Opportunistic pathogen pathogenic organism that is often normally a commensal, but which gives rise to infection in immunocompromised hosts. commensal Living on or within another organism and deriving benefit without injuring or benefiting the other individual.

Symptoms Flu-like symptoms in healthy adults Fever Nausea Vommiting Diarrhea Chills At Risk (in addition to reg. symptoms) Rash Backache Headache Septicemia Meningitis Encephalitis Abortions Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Encephalitis is an acute inflammation of the brain

Implicated Foods Soft mexican style cheese 1st documented outbreak in 1982 160 people ill Luncheon Meat Frankfurtures Cooked products – eliminates competing bacteria

Vibrio Rods Foodborne Infection Non-spore Forming Types:
V. parahaemolyticus V. vulnificus V. cholerae V.alginolyticus Illness: Vibrio parahaemolyticus Gastroenteritis Japan – most common cause of FBI Implicated Foods: Raw or partially cooked oysters

Vibrio vulnificus Diseases:
Vibrio vulnificus Primary Septicemia- Most common At risk populations (liver disease) – 70 to 80% mortality Fever/Chills Nausea Skin Lesions Diarrhea and vomiting Vibrio vulnificus Gastroenteritis – Less common Diarrhea Abdominal cramps

Vibrio Vibrio cholerae Vibrio alginolyticus Disease: Cholera
Habitat: GI tract of humans Symptoms High fever, Severe watery diarrhea Dehydration, Cardiovascular collapse, Death Pandemic – worldwide outbreak Vibrio alginolyticus Habitat: Marine Environment Causes Wound Infections Soft tissue, Ear From a local disease, cholera became one of the most widespread and deadly diseases of the 19th century, killing an estimated tens of millions of people.[31] In Russia alone, between 1847 and 1851, it is estimated that the death toll exceeded one million.[32] In the United States, there were 150,000 cholera deaths during the second pandemic.[33] In the two decades between 1900 and 1920, perhaps eight million Indians died of cholera

Vibrio Implicated Food: Raw or partially cooked shellfish (Bivalves- two shells) Bioaccumulators – accumulate toxins Prevention Measures Purchase oysters from approved source Cook oysters to required minimum internal temperatures Light steaming improves safety but not fool proof.

Shellfish Stock ID tags
Must post WARNING: Eating raw Shellfish could be hazardous to heath At-risk populations should not eat raw Shellfish Shellfish Stock ID tags Live, raw shellfish (shell still closed) ID tags When harvested Where harvested By whom harvested Packer

Foodborne intoxication
Endotoxin – Toxin that is produced by a cell and is then expelled outside of the cell Exotoxin – Toxin that is produced and remains inside the cell until the ruptures (cell death) and is then released Types of toxins based on target organ Enterotoxin – of the intestines; GI tract Neurotoxin – Affects the CNS Hepatotoxin – Affects the liver Nephrotoxin – Affects the kidneys

Bacillus cereus Spore Former – Produces an Endospore Habitat: Soil
Facultative Aerobe Cells – Rod shape Facultative aerobes can use oxygen, but also have anerobic methods of energy production.

Bacillus cereus Symptoms Common Foods Watery diarrhea
Abdominal cramps/Pain Nausea, Vomiting Common Foods Cooked Corn Cooked Potatoes Cooked Vegetables Meat Products Cooked Rice dishes: Fried Rice Rice Pudding Starchy Foods Potatoes Pastas

B. Cereus – emetic type Common Foods Symptoms Onset: 15 min – 6 hrs
Cooked Rice dishes: Fried Rice Rice Pudding Starchy Foods Potatoes Pastas Symptoms Nausea Vomiting Diarrhea, occasionally Abdominal cramps, occasionally Onset: 15 min – 6 hrs Duration: less than 24 hr

Prevention Measures Cook food to required minimum internal temperature
Prevent Bacterial Growth and Toxin Production Hold food at the proper temperature Cool food Properly

Staphylococcus aureus
Cocci shape Habitat: Hair, nose, throat, feathers and sores/boils/pimples Disease: Staphylococcal Gastroenteritis FB Intoxication – Exotoxin Enterotoxin Symptoms: Nausea, Vomiting, Diarrhea Abdominal pain, Headache Sweating, with a decrease in body temp. Scientist Dak – fed christmas cake to graduate students

Implicated Foods High protein foods which are cooked Meat, poultry, gravies, puddings, egg products Salads containing PHF (egg, tuna, chicken, macaroni) Common associations Temperature abuse Foods on hot holding lines not hot enough Refrigeration not cold enough Re-contamination from humans potentially hazardous foods ( PHF)

Prevention Measures Personal Hygiene Properly coved cuts on hands and arms Restrict infected food handlers from working with or around food or food equipment Minimize the time food spends in the Temperature Danger Zone Cook, hold and cool food properly The temperature range in which foodborne bacteria can grow is known as the danger zone. This is typically considered to be between 40°F (4.4°C) and 140°F (60°C)[1], though often 45°F (7.2°C) is considered the lower temperature of the range[2]. According to the 2005 FDA Food Code, the danger zone is defined as 41°F - 135°F (5°C - 57°C). Potentially hazardous food should not be stored at temperatures in this range in order to prevent foodborne illness, and food that remains in this zone for more than four hours must be discarded.

Clostridium botulinum
Rod shaped Obligate anaerobe Spore Former Habitat: Soil, Air, Water Food Intoxication Exotoxins All neurotoxins Heat stable to a point (Boil for 10 min)

Disease: Botulism Botulism toxin mechanism Blocks the release of a neurotransmitter Acetylcholine Causes Paralysis Symptoms Nausea, Vomiting, Abdominal pain Diarrhea (constipation), Headache Diplopia, Speech impairment, Incordination Paralysis, Cardiac Failure Respiratory Failure, Death Diplopia- double vision Treatment: Antitoxin – effective only on unbound toxin Supportive Therapy

Implicated Foods Improperly canned foods (often home-canned) FDA regulation – NO home-canned foods may be served Modified Atmosphere Packaging Controlled Atmosphere Other Foods Baked potatoes Garlic-in-oil Sautéed onions Processed meats Nitrates/Nitrites Baked potatoes – used for potato salad Nitrates/Nitrites control germination and growth of C. bot

Control Avoid temperature abuse of Potentially Hazardous Food Use only commercially prepared canned foods Infant botulism – toxin mediated infection “Floppy Baby Syndrome” Underdeveloped gut flora Honey/Syrup – not under 1 yr of age Botulinum spores are widely found throughout nature, although honey tends to harbor them more than other foods. In fact, botulinum can appear in other sweeteners, such as maple syrup, as well as corn syrup. Botulinum can even be found in dust, indicating that it is an extremely widespread toxin. As a result, most humans adapt to it and are able to fend off small amounts of the toxin, such as those present in honey. Infants, however, do not have a completely matured digestive system and are susceptible to botulism food poisoning. While honey does not always contain the spores, it is more likely to contain botulinum than some other food products, and therefore parents are recommended to avoid it unless it is pasteurized.

Clostridium perfringens
Rod shaped Obligate anaerobe – NO O2 Spore Former Habitat: Ubiquitous - Soil, Air, Water, GI tract Toxin-mediated infection Doesn’t compete well Double every 8 minutes in right environment 2-6% of humans are asymptomatic carriers

Clostridium perfringens
Disease: Clostridium perfringens Gastroenteritis Symptoms: Violent cramps Explosive diarrhea – due to gas production Headache Nausea NO vomiting Onset: 8-22 hours Duration: 1-2 days Infective dose: High 106 or more cells

Escherichia coli Both pathogenic and non-pathogenic serotypes
Habitat: GI tract of humans and animals Rod shape Non-spore forming 5 types of Enterovirulent E. coli Enterotoxigenic -- Enteroinvasive Enteropathogenic Enterohemorrhagic Enteroaggregative

Enterotoxigenic – ETEC
Toxin-mediated infection Disease – Traveler’s Diarrhea Symptoms: Abdominal pain, Nausea, Vomiting, Watery Diarrhea, and Fever Polluted Water Enteropathogenic – EPEC Severe form of infant diarrhea 1940s & 1950s high mortality rate

Enteroaggregative - EAggEC
Infant diarrhea Enteroinvasive – EIEC Bacilliary Dysentary Invades intestinal cells Symptoms Bloody diarrhea Nausea Vomiting Fever Chills

Enterohemorrhagic - EHEC
Shiga toxin-producing E. coli *E. coli O157:H7 (Shiga like toxin I and II) O26:H11 O111:H8 Habitat: GI tract of cattle and humans Common Associated foods Ground beef (raw and undercooked) “Mature beef” – older/dairy cattle Contaminated produce

EHEC Diseases Infective dose - < 50 cells Hemorragic Colitis - HC
More common Affects colon Hemolytic Uremic Syndrome - HUS Affects Kidneys Septcemia - “blood poisoning” Infective dose - < 50 cells Toxins make veins friable – leak Destroy kidney tissue

Major Outbreak Control Jack-In-the-Box
600 ill 3 deaths Control Ground Beef – Cook Internal Temp FDA 155°F for 15 sec. USDA 160°F for 15 sec @ risk/medicare - 165°F for 15 sec Nitrates Pasturization of Juices Hand Washing Avoid Cross-contamination six states, Washington, nevada, idaho, and california

Illnesses caused by Viruses

Virus Non-living Smallest microbial contaminant
Must have a host to reproduce Do not consume nutrients Do not excrete waste products Protein coat with DNA/RNA Smallest microbial contaminant Submicroscopic

Virus Low Infective Doses Many virus resistant to:
Fairly communicable through foods and direct contact Many virus resistant to: Sanitizers Freezing Heat Resistance varies greatly

Hepatitis A Infectious Hepatitis A
Disease of the liver Multiple types of Hepatitis A,B,C,D,E,F A – only one relevant to food service Sources of A Human GI tract --RTE foods Polluted H2O Raw Shellfish Raw fish / Crustaceans B and C are spread through bodily fluids not food Deli meat Produce Salads

Hepatitis A Disease can vary greatly from mild to life threatening
Nausea -- Fever Diarrhea -- Fatigue Vomiting -- Abdominal Pain *Jaundice -- liver enlargement Onset: 15 – 50 days Duration: varies, 1-2 weeks to indefinite

Hepatitis A Can still be infectious weeks after symptoms gone
Spread via fecal-oral route Prevention Good Personal Hygeine Exclude all infected workers NO raw shellfish Purchase from reputable suppliers Steam shellfish for 90 sec ( ° F/ 4min) Inform high risk populations

Norovirus Disease: Norovirus Gastroenteritis
1st outbreak – Norwok, Ohio Contaminated drinking water Non-life threatening EXTREAMLY Contagious Low Infectious dose Contagious for 3 days after symptoms disappear Symptoms Diarrhea, Vomiting Cramps, Nausea Headache, Anorexia

Norovirus Implicated Foods Resistant to Chlorine Sanitizers Prevention
RTE Shellfish contaminated by sewage AKA – “Cruise Ship Poisoning” Resistant to Chlorine Sanitizers Prevention Good Personal Hygiene Exclude all infected workers NO raw shellfish Purchase from reputable suppliers

Parasites Living Organisms Larger than Bacteria
Require host to survive Larger than Bacteria Often still require microscope

Trichinella spiralis Illness: Trichinosis Food of concern – Pork
Habitat – Swine, boar, wild boar, marine mammals, fox Prevention Cooking - 145°F Freezing 5°F for 30 days Curing/Salting/Smoking Irradiation Purchase Pork from approved sources Avoid Cross-contamination with other meats and grinders

Anisakis simplex Disease: Anisakiasis Fish Parasite
Nematode – Round worm Fish and Squid – Bottom feeders Marine – Salt Water Implicated foods – Raw/undercooked fish Sushi --Pacific salmon Ceviche --Cod Sashimi Pickled Herring Herrings are small oily fish

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