Transcript The Microworld

The Microworld
Foodborne Diseases
Definitions
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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.
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( typically symptoms of foodborne illness
do not appear immediately)
Definitions
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Foodborne intoxication
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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
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Foodborne Toxin-mediated
(Toxicoinfection) infection
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Result of a person eating food containing
pathogens which then produce illnesscausing
toxins in the intestines.
Gastrointestinal illness
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Illness relating to the stomach or intestine
Campylobacter jejuni
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Foodborne Infection
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Microaerophilic
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Curved Rod shape
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#1 cause of bacterial foodborne illness in U.S.
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Est. 2-4 million cases a year
Guillian Barré Syndrome
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Neuromuscular disease
Campylobacter jejuni
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Common Foods
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Poultry
Contaminated Water
Prevention Measures
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Cook Food particularly poultry, to required
minimum internal temperatures
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Prevent Cross-contamination between raw
and ready-to-eat food.
Salmonella spp.
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Illness: Salmonlellosis
2,300 serovars
Rod shaped, Non-spore forming
Facultative Anaerobe
Asymptomatic carrier
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Carry pathogenic organism without
symptoms
“typhoid mary” – Mary Malone
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53 people, 7 outbreaks, 3 deaths
Classification based on Disease
Syndrome
1.
Typhoid fever
2.
Paratyphoid fever
3.
Salmonellosis (Gastroenteritis)
Salmonella typhi
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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
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Severe Diarrhea
Vomiting
Dehydration
Cartiovascular collapse
Death
Salmonella paratyphi
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Habitat: GI tract of humans, Polluted
H2O
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Similar to typhoid fever but not as
severe
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Disease : paratyphiod fever
Salmonellosis/Gastroenteritis
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Foodborne Infection
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Severity depends on health, age, # cells
Onset: 6 – 72 hrs
Duration: 2-3 days
Symptoms
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Nausea, Vomiting, Diarrhea
Headache, Fever, Chills
Sweating, Weakness
Salmonellosis/Gastroenteritis
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Carriers/Implicated foods
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Poultry – meat and eggs
Cattle – beef and dairy prod.
Swine – pork
RTE foods
Other implicated foods
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Wildgame
Orange juice
Alfalfa sprouts
Nuts – Snickers
Cantaloupes/Melons
Control of Salmonella
1.
2.
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
3.
Avoid Cross Contamination
Shigella spp.
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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
Shigellosis
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Disease of Armys, Asylums, and Prisons
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Concentrated people
Dorms, school systems, military
Symptoms
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Nausea, Vomiting
Abdominal Pain
Diarrhea (watery/bloody)
Fever/Chills
Prostration, Fatigue
Sever cases - HUS
Shigellosis
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Onset: 1-3 days
Duration: 4 days or more
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Most often , BUT Not always self limiting
Sometimes must use antibiotics
Transmited via fecal-oral route
Food Infection
Shigellosis
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Implicated Foods
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Heavily Handled Foods
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Salads/Lettuce
Ready to Eat Meat products
Control
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Personal Hygeine – Hand Washing
Exclude infected foodhandlers
Control flies inside and outside the
establishment
Listeria monocytogenes
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Rod
Non-spore forming
Psychrophile
Anaerobic
Habitat:
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Decaying vegetative mater
Soil
GI tract of animals and humans
Cool, wet, damp processing environments
Listeria monocytogenes
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Disease: Listeriosis
Onset: 3 to 70 days
Occurs most frequently in at risk
populations
Opportunistic Pathogen
Prevention:
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Watch sell-by date
Prevent cross-contamination
Cook meat to proper temperature
Listeria monocytogenes
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Symptoms
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Flu-like symptoms
in healthy adults
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Fever
Nausea
Vommiting
Diarrhea
Chills
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At Risk (in addition
to reg. symptoms)
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Rash
Backache
Headache
Septicemia
Meningitis
Encephalitis
Abortions
Listeria monocytogenes
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Implicated Foods
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Soft mexican style cheese
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Luncheon Meat
Frankfurtures
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1st documented outbreak in 1982
160 people ill
Cooked products – eliminates competing bacteria
Cooked products – eliminates competing
bacteria
Vibrio
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Rods
Foodborne Infection
Non-spore Forming
Types:
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V. parahaemolyticus
V. vulnificus
V. cholerae
V.alginolyticus
Illness: Vibrio parahaemolyticus Gastroenteritis
Japan – most common cause of FBI
Implicated Foods:
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Raw or partially cooked oysters
Vibrio vulnificus
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Diseases:
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Vibrio vulnificus Primary Septicemia- Most
common
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At risk populations (liver disease) – 70 to 80%
mortality
Fever/Chills
Nausea
Skin Lesions
Diarrhea and vomiting
Vibrio vulnificus Gastroenteritis – Less common
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Diarrhea
Abdominal cramps
Vibrio
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Vibrio cholerae
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Disease: Cholera
Habitat: GI tract of humans
Symptoms
 High fever, Severe watery diarrhea
 Dehydration, Cardiovascular collapse, Death
Pandemic – worldwide outbreak
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Vibrio alginolyticus
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Habitat: Marine Environment
Causes Wound Infections
 Soft tissue, Ear
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Vibrio
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Implicated Food: Raw or partially cooked
shellfish (Bivalves- two shells)
Bioaccumulators – accumulate toxins
Prevention Measures
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Purchase oysters from approved source
Cook oysters to required minimum internal
temperatures
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Light steaming improves safety but not fool proof.
• 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
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When harvested
Where harvested
By whom harvested
Packer
Foodborne intoxication
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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
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Enterotoxin – of the intestines; GI tract
Neurotoxin – Affects the CNS
Hepatotoxin – Affects the liver
Nephrotoxin – Affects the kidneys
Bacillus cereus
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Spore Former – Produces an
Endospore
Habitat: Soil
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Facultative Aerobe
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Cells – Rod shape
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Bacillus cereus
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Symptoms
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Watery diarrhea
Abdominal cramps/Pain
Nausea,
Vomiting
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Common Foods
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Cooked Corn
Cooked Potatoes
Cooked Vegetables
Meat Products
Cooked Rice dishes:
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Fried Rice
Rice Pudding
Starchy Foods
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Potatoes
Pastas
B. Cereus – emetic type
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Symptoms
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Nausea
Vomiting
Diarrhea, occasionally
Abdominal cramps,
occasionally
Onset: 15 min – 6 hrs
Duration: less than 24 hr
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Common Foods
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Cooked Rice dishes:
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Fried Rice
Rice Pudding
Starchy Foods
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Potatoes
Pastas
Prevention Measures
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Cook food to required minimum internal
temperature
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Prevent Bacterial Growth and Toxin Production
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Hold food at the proper
temperature
Cool food Properly
Staphylococcus aureus
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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.
Staphylococcus aureus
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Implicated Foods
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High protein foods which are cooked
Meat, poultry, gravies, puddings, egg products
Salads containing PHF (egg, tuna, chicken,
macaroni)
Common associations
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Temperature abuse
Foods on hot holding lines not hot enough
Refrigeration not cold enough
Re-contamination from humans
Staphylococcus aureus
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Prevention Measures
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Personal Hygiene
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Properly coved cuts on hands and arms
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Restrict infected food handlers from working
with or around food or food equipment
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Minimize the time food spends in the
Temperature Danger Zone
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Cook, hold and cool food properly
Clostridium botulinum
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Rod shaped
Obligate anaerobe
Spore Former
Habitat: Soil, Air, Water
Food Intoxication
Exotoxins
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All neurotoxins
Heat stable to a point (Boil for 10 min)
Clostridium botulinum
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Disease: Botulism
Botulism toxin mechanism
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Blocks the release of a neurotransmitter
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Acetylcholine
Causes Paralysis
Symptoms
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Nausea, Vomiting, Abdominal pain
Diarrhea (constipation), Headache
Diplopia, Speech impairment, Incordination
Paralysis, Cardiac Failure
Respiratory Failure, Death
Clostridium botulinum
Implicated Foods
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Improperly canned foods (often home-canned)
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FDA regulation – NO home-canned foods may be served
Modified Atmosphere Packaging
Controlled Atmosphere
Other Foods
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Baked potatoes
Garlic-in-oil
Sautéed onions
Processed meats
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Nitrates/Nitrites
Clostridium botulinum
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Control
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Avoid temperature abuse of Potentially
Hazardous Food
Use only commercially prepared canned
foods
Infant botulism – toxin mediated infection
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“Floppy Baby Syndrome”
Underdeveloped gut flora
Honey/Syrup – not under 1 yr of age
Clostridium perfringens
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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
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Disease:
Clostridium perfringens Gastroenteritis
Symptoms:
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Violent cramps
Explosive diarrhea – due to gas production
Headache
Nausea
NO vomiting
Escherichia coli
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Both pathogenic and non-pathogenic
serotypes
Habitat: GI tract of humans and animals
Rod shape
Non-spore forming
5 types of Enterovirulent E. coli
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Enterotoxigenic
Enteropathogenic
Enterohemorrhagic
Enteroaggregative
-- Enteroinvasive
• 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
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Bloody diarrhea
Nausea
Vomiting
Fever
Chills
Enterohemorrhagic - EHEC
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Shiga toxin-producing E. coli
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*E. coli O157:H7 (Shiga like toxin I and II)
O26:H11
O111:H8
Habitat: GI tract of cattle and humans
Common Associated foods
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Ground beef (raw and undercooked)
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“Mature beef” – older/dairy cattle
Contaminated produce
EHEC
• Diseases
– Hemorragic Colitis - HC
• More common
• Affects colon
– Hemolytic Uremic Syndrome - HUS
• Affects Kidneys
• Septcemia - “blood poisoning”
• Infective dose - < 50 cells
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Major Outbreak
– Jack-In-the-Box
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600 ill
3 deaths
Control
1. Ground Beef – Cook Internal Temp
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FDA 155°F for 15 sec.
USDA 160°F for 15 sec
@ risk/medicare - 165°F for 15 sec
Nitrates
2. Pasturization of Juices
3. Hand Washing
4. Avoid Cross-contamination
Illnesses caused by
Viruses
Virus
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Non-living
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Must have a host to reproduce
Do not consume nutrients
Do not excrete waste products
Protein coat with DNA/RNA
Smallest microbial contaminant
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Submicroscopic
Virus
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Low Infective Doses
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Many virus resistant to:
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Fairly communicable through foods and
direct contact
Sanitizers
Freezing
Heat
Resistance varies greatly
Hepatitis A
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Infectious Hepatitis A
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Multiple types of Hepatitis A,B,C,D,E,F
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Disease of the liver
A – only one relevant to food service
Sources of A
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Human GI tract
--RTE foods
• Deli meat
Polluted H2O
• Produce
Raw Shellfish
• Salads
Raw fish / Crustaceans
Hepatitis A
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Disease can vary greatly from mild to
life threatening
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Nausea
Diarrhea
Vomiting
*Jaundice
-- Fever
-- Fatigue
-- Abdominal Pain
-- liver enlargement
Hepatitis A
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Can still be infectious weeks after symptoms
gone
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Spread via fecal-oral route
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Prevention
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Good Personal Hygeine
Exclude all infected workers
NO raw shellfish
Purchase from reputable suppliers
Steam shellfish for 90 sec (184-194° F/ 4min)
Norovirus
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Disease: Norovirus Gastroenteritis
1st outbreak – Norwok, Ohio
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Contaminated drinking water
Non-life threatening
Symptoms
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Diarrhea, Vomiting
Cramps, Nausea
Headache, Anorexia
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EXTREAMLY
Contagious
Low Infectious dose
Contagious for 3
days after symptoms
disappear
Norovirus
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Implicated Foods
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RTE
Shellfish contaminated by sewage
AKA – “Cruise Ship Poisoning”
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Resistant to Chlorine Sanitizers
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Prevention
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Good Personal Hygiene
Exclude all infected workers
NO raw shellfish
Purchase from reputable suppliers
Parasites
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Living Organisms
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Require host to survive
Larger than Bacteria
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Often still require microscope
Trichinella spiralis
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Illness: Trichinosis
Food of concern – Pork
Habitat – Swine, boar, wild boar, marine
mammals, fox
Prevention
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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
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Disease: Anisakiasis
Fish Parasite
Nematode – Round worm
Fish and Squid – Bottom feeders
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Marine – Salt Water
Implicated foods – Raw/undercooked fish
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Sushi
--Pacific salmon
Ceviche
--Cod
Sashimi
Pickled Herring