2 Foodborne DiseasesIntoxication – Ingestion of toxins present in the foodToxins formed and secreted by microorganisms during growth in food & make you sickToxico-infection – Bacteria grow in food, no toxins producedPathogenic bacteria enter the bodyToxins produced during growth in intestinal tract and you get sickInfection - Pathogenic bacteria enter body and invade cells of intestinal mucosaMultiplication within mucosal cells or spreading to other organsJust bacteria makes you sick
3 DefinitionsFoodborne 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
4 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.
5 Definitions Foodborne Toxin-mediated (Toxicoinfection) infection Result of a person eating food containing pathogens which then produce illness-causingtoxins in the intestines.Gastrointestinal illnessIllness relating to the stomach or intestine
6 Campylobacter jejuni Foodborne Infection Microaerophilic Curved Rod shape#1 cause of bacterial foodborne illness in U.S.Est. 2-4 million cases a yearGuillian Barré SyndromeNeuromuscular disease
7 Campylobacter jejuni Common Foods Prevention Measures Poultry Contaminated WaterPrevention MeasuresCook Food particularly poultry, to required minimum internal temperaturesPrevent Cross-contamination between raw and ready-to-eat food.
8 Salmonella spp. Illness: Salmonlellosis 2,300 serovars Rod shaped, Non-spore formingFacultative AnaerobeAsymptomatic carrierCarry pathogenic organism without symptoms“typhoid mary” – Mary Malone53 people, 7 outbreaks, 3 deathsA 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 pathogensFacultative Anaerobe – Able to grow in both the presence and absence of oxygen“typhoid mary” – Mary Malone ( )Salmonella typhiUS 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.
9 Classification based on Disease Syndrome Typhoid feverParatyphoid feverSalmonellosis (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. 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 appearParatyphoid fever is an illness caused by the bacterium Salmonella Paratyphi. The paratyphoid bears similarities with typhoid fever, but its course is more benignGastroenteritis involves diarrhoea or vomiting, with noninflammatory infection of the upper small bowel, or inflammatory infection of the colon, both part of the gastrointestinal tract.
10 Salmonella typhi Habitat: GI tract of humans, polluted H2O Vaccine Poor SanitationNot common in U.S.Infectious dose – 1-10 cellsTyphoid fever (Typhoid fever – once you have it cant get it again)high fever – 105° FSevere DiarrheaVomitingDehydrationCartiovascular collapseDeathcirculatory 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 or trauma from injury or surgeryCardiac 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.
11 Salmonella paratyphi Habitat: GI tract of humans, Polluted H2O Similar to typhoid fever but not as severeDisease : paratyphiod fever
14 Control of Salmonella Personal hygiene – Hand washing Cooking/PasteurizationPoultry 165°F for 15 sec.EggsRaw or undercooked or minimally cooked eggs – pasteurized egg productKeep adequately refrigerated will prevent any Salmonella present in the eggs from growing to higher numbersAvoid Cross ContaminationReduce 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.
15 Shigella spp. Rod Shaped Habitat – GI tract of humans Small infective dose – 10 cellsEasily transmissible because of low infectious doseFoodborne infectionDisease: Shigellosis or Bacilliary dysentaryThe 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.
16 Shigellosis Disease of Armys, Asylums, and Prisons Symptoms Concentrated peopleDorms, school systems, militarySymptomsNausea, VomitingAbdominal PainDiarrhea (watery/bloody)Fever/ChillsProstration, FatigueSever cases - HUSprostration - a condition marked by dizziness and nausea and weakness caused by depletion of body fluids and electrolytes"HUS" hemolytic uremic syndromeis a predominantly pediatric conditionis a disease characterised by microangiopathic hemolytic anemia, acute renal failure and a low platelet countmicroangiopathic hemolytic anemia (MAHA) is a subgroup of hemolytic anemia (anemia, loss of red blood cells through destruction
17 Shigellosis Onset: 1-3 days Duration: 4 days or more Most often , BUT Not always self limitingSometimes must use antibioticsTransmited via fecal-oral routeFood Infectionself-limiting organism or colony of organisms limits its own growth by its actions
18 Shigellosis Implicated Foods Control Heavily Handled Foods Salads/LettuceReady to Eat Meat productsControlPersonal Hygeine – Hand WashingExclude infected foodhandlersControl flies inside and outside the establishment
19 Listeria monocytogenes RodNon-spore formingPsychrophileAnaerobicHabitat:Decaying vegetative materSoilGI tract of animals and humansCool, wet, damp processing environmentsPsychrophile capable of growth and reproduction in cold temperaturesCan grow at 1 degree Celsius(33.8 degrees Fahrenheit)
20 Listeria monocytogenes Disease: ListeriosisOnset: 3 to 70 daysOccurs most frequently in at risk populationsOpportunistic PathogenPrevention:Watch sell-by datePrevent cross-contaminationCook meat to proper temperatureOpportunistic pathogenpathogenic 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.
21 Listeria monocytogenes SymptomsFlu-like symptoms in healthy adultsFeverNauseaVommitingDiarrheaChillsAt Risk (in addition to reg. symptoms)RashBackacheHeadacheSepticemiaMeningitisEncephalitisAbortionsMeningitis 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
22 Listeria monocytogenes Implicated FoodsSoft mexican style cheese1st documented outbreak in 1982160 people illLuncheon MeatFrankfurturesCooked products – eliminates competing bacteria
23 Vibrio Rods Foodborne Infection Non-spore Forming Types: V. parahaemolyticusV. vulnificusV. choleraeV.alginolyticusIllness: Vibrio parahaemolyticus GastroenteritisJapan – most common cause of FBIImplicated Foods:Raw or partially cooked oysters
24 Vibrio vulnificus Diseases: Vibrio vulnificus Primary Septicemia- Most commonAt risk populations (liver disease) – 70 to 80% mortalityFever/ChillsNauseaSkin LesionsDiarrhea and vomitingVibrio vulnificus Gastroenteritis – Less commonDiarrheaAbdominal cramps
25 Vibrio Vibrio cholerae Vibrio alginolyticus Disease: Cholera Habitat: GI tract of humansSymptomsHigh fever, Severe watery diarrheaDehydration, Cardiovascular collapse, DeathPandemic – worldwide outbreakVibrio alginolyticusHabitat: Marine EnvironmentCauses Wound InfectionsSoft tissue, EarFrom 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. In Russia alone, between 1847 and 1851, it is estimated that the death toll exceeded one million. In the United States, there were 150,000 cholera deaths during the second pandemic. In the two decades between 1900 and 1920, perhaps eight million Indians died of cholera
26 VibrioImplicated Food: Raw or partially cooked shellfish (Bivalves- two shells)Bioaccumulators – accumulate toxinsPrevention MeasuresPurchase oysters from approved sourceCook oysters to required minimum internal temperaturesLight steaming improves safety but not fool proof.
27 Shellfish Stock ID tags Must post WARNING:Eating raw Shellfish could be hazardous to heathAt-risk populations should not eat raw ShellfishShellfish Stock ID tagsLive, raw shellfish (shell still closed)ID tagsWhen harvestedWhere harvestedBy whom harvestedPacker
28 Foodborne intoxication Endotoxin – Toxin that is produced by a cell and is then expelled outside of the cellExotoxin – Toxin that is produced and remains inside the cell until the ruptures (cell death) and is then releasedTypes of toxins based on target organEnterotoxin – of the intestines; GI tractNeurotoxin – Affects the CNSHepatotoxin – Affects the liverNephrotoxin – Affects the kidneys
29 Bacillus cereus Spore Former – Produces an Endospore Habitat: Soil Facultative AerobeCells – Rod shapeFacultative aerobes can use oxygen, but also have anerobic methods of energy production.
31 B. Cereus – emetic type Common Foods Symptoms Onset: 15 min – 6 hrs Cooked Rice dishes:Fried RiceRice PuddingStarchy FoodsPotatoesPastasSymptomsNauseaVomitingDiarrhea, occasionallyAbdominal cramps, occasionallyOnset: 15 min – 6 hrsDuration: less than 24 hr
32 Prevention Measures Cook food to required minimum internal temperature Prevent Bacterial Growth and Toxin ProductionHold food at the propertemperatureCool food Properly
33 Staphylococcus aureus Cocci shapeHabitat: Hair, nose, throat, feathers and sores/boils/pimplesDisease: Staphylococcal GastroenteritisFB Intoxication – ExotoxinEnterotoxinSymptoms:Nausea, Vomiting, DiarrheaAbdominal pain, HeadacheSweating, with a decrease in body temp.Scientist Dak – fed christmas cake to graduate students
34 Staphylococcus aureus Implicated FoodsHigh protein foods which are cookedMeat, poultry, gravies, puddings, egg productsSalads containing PHF (egg, tuna, chicken, macaroni)Common associationsTemperature abuseFoods on hot holding lines not hot enoughRefrigeration not cold enoughRe-contamination from humanspotentially hazardous foods ( PHF)
35 Staphylococcus aureus Prevention MeasuresPersonal HygieneProperly coved cuts on hands and armsRestrict infected food handlers from working with or around food or food equipmentMinimize the time food spends in the Temperature Danger ZoneCook, hold and cool food properlyThe 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), though often 45°F (7.2°C) is considered the lower temperature of the range. 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.
36 Clostridium botulinum Rod shapedObligate anaerobeSpore FormerHabitat: Soil, Air, WaterFood IntoxicationExotoxinsAll neurotoxinsHeat stable to a point (Boil for 10 min)
37 Clostridium botulinum Disease: BotulismBotulism toxin mechanismBlocks the release of a neurotransmitterAcetylcholineCauses ParalysisSymptomsNausea, Vomiting, Abdominal painDiarrhea (constipation), HeadacheDiplopia, Speech impairment, IncordinationParalysis, Cardiac FailureRespiratory Failure, DeathDiplopia- double visionTreatment:Antitoxin – effective only on unbound toxinSupportive Therapy
38 Clostridium botulinum Implicated FoodsImproperly canned foods (often home-canned)FDA regulation – NO home-canned foods may be servedModified Atmosphere PackagingControlled AtmosphereOther FoodsBaked potatoesGarlic-in-oilSautéed onionsProcessed meatsNitrates/NitritesBaked potatoes – used for potato saladNitrates/Nitrites control germination and growth of C. bot
39 Clostridium botulinum ControlAvoid temperature abuse of Potentially Hazardous FoodUse only commercially prepared canned foodsInfant botulism – toxin mediated infection“Floppy Baby Syndrome”Underdeveloped gut floraHoney/Syrup – not under 1 yr of ageBotulinum 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.
40 Clostridium perfringens Rod shapedObligate anaerobe – NO O2Spore FormerHabitat: Ubiquitous - Soil, Air, Water, GI tractToxin-mediated infectionDoesn’t compete wellDouble every 8 minutes in right environment2-6% of humans are asymptomatic carriers
41 Clostridium perfringens Disease:Clostridium perfringens GastroenteritisSymptoms:Violent crampsExplosive diarrhea – due to gas productionHeadacheNauseaNO vomitingOnset: 8-22 hoursDuration: 1-2 daysInfective dose: High 106 or more cells
42 Escherichia coli Both pathogenic and non-pathogenic serotypes Habitat: GI tract of humans and animalsRod shapeNon-spore forming5 types of Enterovirulent E. coliEnterotoxigenic -- EnteroinvasiveEnteropathogenic EnterohemorrhagicEnteroaggregative
43 Enterotoxigenic – ETEC Toxin-mediated infectionDisease – Traveler’s DiarrheaSymptoms:Abdominal pain, Nausea, Vomiting, Watery Diarrhea, and FeverPolluted WaterEnteropathogenic – EPECSevere form of infant diarrhea1940s & 1950s high mortality rate
45 Enterohemorrhagic - EHEC Shiga toxin-producing E. coli*E. coli O157:H7 (Shiga like toxin I and II)O26:H11O111:H8Habitat: GI tract of cattle and humansCommon Associated foodsGround beef (raw and undercooked)“Mature beef” – older/dairy cattleContaminated produce
47 Major Outbreak Control Jack-In-the-Box 600 ill3 deathsControlGround Beef – Cook Internal TempFDA 155°F for 15 sec.USDA 160°F for 15 sec@ risk/medicare - 165°F for 15 secNitratesPasturization of JuicesHand WashingAvoid Cross-contaminationsix states, Washington, nevada, idaho, and california
49 Virus Non-living Smallest microbial contaminant Must have a host to reproduceDo not consume nutrientsDo not excrete waste productsProtein coat with DNA/RNASmallest microbial contaminantSubmicroscopic
50 Virus Low Infective Doses Many virus resistant to: Fairly communicable through foods and direct contactMany virus resistant to:SanitizersFreezingHeatResistance varies greatly
51 Hepatitis A Infectious Hepatitis A Disease of the liverMultiple types of Hepatitis A,B,C,D,E,FA – only one relevant to food serviceSources of AHuman GI tract --RTE foodsPolluted H2ORaw ShellfishRaw fish / CrustaceansB and C are spread through bodily fluids not foodDeli meatProduceSalads
52 Hepatitis A Disease can vary greatly from mild to life threatening Nausea -- FeverDiarrhea -- FatigueVomiting -- Abdominal Pain*Jaundice -- liver enlargementOnset: 15 – 50 daysDuration: varies, 1-2 weeks to indefinite
53 Hepatitis A Can still be infectious weeks after symptoms gone Spread via fecal-oral routePreventionGood Personal HygeineExclude all infected workersNO raw shellfishPurchase from reputable suppliersSteam shellfish for 90 sec ( ° F/ 4min)Inform high risk populations
54 Norovirus Disease: Norovirus Gastroenteritis 1st outbreak – Norwok, OhioContaminated drinking waterNon-life threateningEXTREAMLY ContagiousLow Infectious doseContagious for 3 days after symptoms disappearSymptomsDiarrhea, VomitingCramps, NauseaHeadache, Anorexia
55 Norovirus Implicated Foods Resistant to Chlorine Sanitizers Prevention RTEShellfish contaminated by sewageAKA – “Cruise Ship Poisoning”Resistant to Chlorine SanitizersPreventionGood Personal HygieneExclude all infected workersNO raw shellfishPurchase from reputable suppliers
56 Parasites Living Organisms Larger than Bacteria Require host to surviveLarger than BacteriaOften still require microscope
57 Trichinella spiralis Illness: Trichinosis Food of concern – Pork Habitat – Swine, boar, wild boar, marine mammals, foxPreventionCooking - 145°FFreezing 5°F for 30 daysCuring/Salting/SmokingIrradiationPurchase Pork from approved sourcesAvoid Cross-contamination with other meats and grinders
58 Anisakis simplex Disease: Anisakiasis Fish Parasite Nematode – Round wormFish and Squid – Bottom feedersMarine – Salt WaterImplicated foods – Raw/undercooked fishSushi --Pacific salmonCeviche --CodSashimiPickled HerringHerrings are small oily fish