Diseases Acquired through the alimentary route Botulism Hemorrhagic colitis (Escherichia Coli 0157:H7)

Clostridium botulinum  Gram-positive bacteria  Rod shaped  Most commonly found in the soil  Spore forming  Strict anaerobe  Heat sensitive  Prefers low acidic environment

Botulism  Severe intoxication from the exotoxin produced by Clostridium botulinum  Results in a life-threatening paralytic illness  Systemic illness  When the toxin is ingested in contaminated food is absorbed from the intestine into the system, it results in the paralysis of cranial and peripheral nerves

Transmission  Generally the result of eating foods that have been inadequately cooked, allowing the toxin to form  In the U.S. home canned fruit and vegetables have been involved in most botulism cases

Outbreaks  The largest botulism outbreaks in the U.S. in the past 19 yrs. occurred in El Paso, Texas: April 1994  The toxin had formed in aluminum foil-wrapped baked potatoes held at room temperature for several days before they were used in a potato-based dip at a restaurant  30 people were affected and 4 required mechanical ventilation

Symptoms  The first signs generally relate to the effects of the toxin on the nervous system  Person may experience dizziness, difficulty in swallowing, and double vision  Nausea, vomiting, and diarrhea may occur earlier, ant the same time or later  Descending paralysis and death usually occurs from respiratory paralysis

Treatment and Prevention Treatment  Intramuscular (IM) or IV administration of botulinum antitoxin Prevention  Effective control of processing and preparation of commercially canned and preserved foods  Educating everybody that prepares and serves food  Any bulging cans or jars that do not seem sealed should not be opened or used  Potatoes which have been baked while wrapped in aluminum foil should be kept hot until served or refrigerated

E. coli

E. Coli  Gram negative  Morphology: Straight rods  Aerobic/Facultative anaerobic  Not spore forming  Non capsulated and motile

E. Coli  E. coli is a normal inhabitant of the intestines of all animals including humans  Useful function in the body: suppresses the growth of harmful bacterial species and helps in the synthesis of vitamins  Only some E. coli are pathogenic  Cause either diarrhea or illness outside the intestinal wall

E. coli  Consists of a diverse group of bacteria  Pathogenic E. coli strains are categorized into pathotypes  Six pathotypes are associated with diarrhea  EHEC- enterohemorrhagic E. coli: hemorrhagic colitis or hemolytic uremic syndrome  Also referred to as Shiga toxin producing E. coli (STEC)  ETEC- enterotoxogenic E. coli- traveler’s diarrhea  EPEC- enteropathogenic E. coli- childhood diarrhea  EIEC- enteroinvasive E. coli- Shigella like dysentery  EAEC- eteroadherent E. coli- childhood diarrhea, some cases of traveler’s diarrhea  EAggEC- enteroaggregative E. coli- persistent diarrhea in developing countries

Transmission  By ingestion of contaminated food or water  Person to person  Organism can be found in hamburger and other meats  different sources including apple juice, coleslaw, jerky made from dear meat, and alfalfa sprouts 12/index.html Organism responsible for hemorrhagic colitis: Escherichia coli 0157:H7

Symptoms  Severe cramping and diarrhea are the first symptoms  Diarrhea is watery at first, but in most victims, becomes bloody  Occasional vomiting  Low grade fever or none at all  Illness lasts and avg. of 8 days

Treatment  Most cases require not therapy, but fluid replacement may be necessary  Some evidence has shown that antibiotic treatment can increase the risk of complications, but further investigation needs to be done

Prevention  Families of people who are ill need to be educated about possible person-to person transmission  “Ten Golden Rules for Food Preparation” by WHO  Choose food processed for safety  Cook food thoroughly  Eat cooked food immediately  Store cooked food carefully  Reheat cooked foods thoroughly  Avoid contact between raw and cooked foods  What hands repeatedly  Keep all kitchen surfaces meticulously clean  Protect foods from insects, rodents, and other animals  Use pure water