Food safety is a scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness.

This includes a number of routines that should be followed to avoid potentially severe health hazards. The tracks within this line of thought are safety between industry and the market and then between the market and the consumer. In considering industry to market practices, food safety considerations include the origins of food including the practices relating to food labeling, food hygiene, food additives and pesticide residues, as well as policies on biotechnology and food and guidelines for the management of governmental import and export inspection and certification systems for foods. In considering market to consumer practices, the usual thought is that food ought to be safe in the market and the concern is safe delivery and preparation of the food for the consumer. Food can transmit disease from person to person as well as serve as a growth medium for bacteria that can cause food poisoning. In developed countries there are intricate standards for food preparation, whereas in lesser developed countries the main issue is simply the availability of adequate safe water, which is usually a critical item.[1] In theory, food poisoning is 100% preventable. The five key principles of food hygiene, according to WHO, are:[2] Prevent contaminating food with pathogens spreading from people, pets, and pests. Separate raw and cooked foods to prevent contaminating the cooked foods. Cook foods for the appropriate length of time and at the appropriate temperature to kill pathogens. Store food at the proper temperature. Do use safe water and cooked materials. Foodborne diseases remain responsible for high levels of morbidity and mortality in the general population, but particularly for at-risk groups, such as infants and young, children, the elderly and the immunocompromised. In order to reduce the incidence and economic consequences of foodborne diseases, the WHO Department of Food Safety and Zoonoses (FOS) has been assisting the Member States to establish and strengthen their programmes for assuring the safety of food from production to final consumption. In this regard, WHO offers a unique capacity, through its commitment to health, to work collaboratively with government, industry and consumers, to strengthen and better focus national food safety efforts. General information related to foodborne disease

WHO/F. Fontannaz Outbreaks of foodborne disease attract media attention and raise consumer concern. However, cases of foodborne illness occur daily in all countries, from the most to the least developed. As most of these cases are not reported, the true dimension of the problem is unknown, and efforts to secure the resources and support necessary for the identification and implementation of effective solutions often fail.

Effective control of foodborne disease must be based on evaluated information about foodborne hazards and the incidence of foodborne disease. Development of a strategy to reduce food-related risks requires knowledge about the current levels of foodborne disease in Member States. It must also be based on an appreciation of the targets and timeframe for improving food safety. This should be an on-going process, in which new targets are set when old ones are achieved, and progress should be monitored continuously in targeted surveys.

The absence of reliable data on the burden of foodborne disease impedes understanding about its public health importance and prevents the development of risk- based solutions to its management. Innovative strategies and methods are needed for surveying foodborne disease and food contamination. A laboratory-based surveillance system should be based on sentinel sites and regional and/or international laboratory networks. A necessary prerequisite for risk-based strategies based on optimized surveys is an interdisciplinary approach involving strong collaboration among all sectors dealing with foodborne disease surveillance and food safety in the health sector.

WHO will initiate a Global Strategy for the surveillance of foodborne diseases by urging Member States to set up laboratory-based systems covering both outbreaks, sporadic cases and for monitoring contamination of food by chemicals and microorganisms. When requested by Member States, WHO will support capacity building for data collection and surveillance systems. WHO will also establish common, internationally agreed formats for harmonized data collection and determine the minimal data requirements for future food safety initiatives in the regions. WHO will seek to develop a web-based system to collect, report and communicate data from surveys conducted in Member States. Global Foodborne Infections Network (GFN), a surveillance system for Salmonella and antimicrobial resistance, already exists.

LEARN WHERE THEY ARE AND HOW TO AVOID THEM Campylobacter- Second most common bacterial cause of diarrhea in the United States. Sources: raw and undercooked poultry and other meat, raw milk and untreated water.

Clostridium botulinum- This organism produces a toxin which causes botulism, a life-threatening illness that can prevent the breathing muscles from moving air in and out of the lungs. Sources: improperly prepared home-canned foods; honey should not be fed to children less than 12 months old. E. coli O157:H7- A bacterium that can produce a deadly toxin and causes approximately 73,000 cases of foodborne illness each year in the U.S. Sources: beef, especially undercooked or raw hamburger; produce; raw milk; and unpasteurized juices and ciders.

Listeria monocytogenes- Causes listeriosis, a serious disease for pregnant women, newborns, and adults with a weakened immune system. Sources: unpasteurized dairy products, including soft cheeses; sliced deli meats; smoked fish; hot dogs; pate'; and deli-prepared salads (i.e. egg, ham, seafood, and chicken salads). Norovirus- The leading viral cause of diarrhea in the United States. Poor hygiene causes Norovirus to be easily passed from person to person and from infected individuals to food items. Sources: Any food contaminated by someone who is infected with this virus.

Salmonella- Most common bacterial cause of diarrhea in the United States, and the most common cause of foodborne deaths. Responsible for 1.4 million cases of foodborne illness a year. Sources: raw and undercooked eggs, undercooked poultry and meat, fresh fruits and vegetables, and unpasteurized dairy products. Staphylococcus aureus- This bacterium produces a toxin that causes vomiting shortly after being ingested. Sources: cooked foods high in protein (e.g. cooked ham, salads, bakery products, dairy products) that are held too long at room temperature.

Shigella - Causes an estimated 448,000 cases of diarrhea illnesses per year. Poor hygiene causes Shigella to be easily passed from person to person and from infected individuals to food items. Sources: salads, unclean water, and any food handled by someone who is infected with the bacterium. Toxoplasma gondii- Aparasite that causes toxoplasmosis, a very severe disease that can produce central nervous system disorders particularly mental retardation and visual impairment in children. Pregnant women and people with weakened immune systems are at higher risk. Sources: raw or undercooked pork. Vibrio vulnificus- Causes gastroenteritis, wound infection, and severe bloodstream infections. People with liver diseases are especially at high risk. Sources: raw or undercooked seafood, particularly shellfish.

Causes and Symptoms Disease and Organism That Causes It Source of Illness Symptoms

Bacteria These bacteria produce toxin only in an Onset: Generally 4-36 hours after anaerobic (oxygenless) environment of eating. Botulinum toxin (produced by Clostridium little acidity. The spores are heat resistant Symptoms: Neurotoxic symptoms, botulinum bacteria) and can survive in foods that are incorrectly or minimally processed. Most of including double vision, inability to the small number of outbreaks reported swallow, speech difficulty, and progressive paralysis of the annually in the U.S. are associated with respiratory system. inadequately processed, home-canned foods, but occasionally commerciallyGet Medical Help Immediately. produced foods have been inovlved in Botulism Can Be Fatal. outbreaks. Sausages, meat products, canned vegetables and seafood products have been vehicles for human botulism. Botulism Campylobacteriosis Campylobacter jejuni Bacteria on poultry, cattle, and sheep can Onset: Generally 2-5 days after contaminate meat and milk of these eating. animals. Chief raw food sources: raw Symptoms: Diarrhea, abdominal poultry, meat, and unpasteurized milk. cramping, fever, and sometimes bloody stools. Lasts 7-10 days. The bacterium E. coli O157:H7 is a rare but Onset: Generally 2-5 days after dangerous type of E. coli. The organism can eating. be found on a small number of cattle farms Symptoms: Severe bloody diarrhea and can live in the intestines of healthy and abdominal cramps; sometimes cattle. Meat can become contaminated the infection causes nonbloody during slaughter, and organisms can be diarrhea or no symptoms. Usually thoroughly mixed into beef when it is little or no fever is present, and the ground. Bacteria present on the cow's udders or on equipment may get into raw illness resolves in 5 to 10 days. milk. In some persons, particularly children Eating meat, especially ground beef, that under 5 years of age and the elderly, has not been cooked sufficiently to kill E. the infection can also cause a complication called hemolytic uremic coli O157:H7 can cause infection. syndrome (HUS), in which the red Contaminated meat looks and smells normal. Although the number of organisms blood cells are destroyed and the required to cause disease is not known, it kidneys fail. About 2%-7% of infections lead to this complication. is suspected to be very small. In the United States, hemolytic Among other known sources of infection uremic syndrome is the principal cause of acute kidney failure in are consumption of sprouts, lettuce, salami, unpasteurized milk and juice, and children, and most cases of hemolytic uremic syndrome are caused by E. swimming in or drinking sewage-

E-coli O157:H7 Escherichia coli O157:H7

contaminated water. Bacteria in diarrheal stools of infected persons can be passed from one person to another if hygiene or handwashing habits are inadequate. This is particularly likely among toddlers who are not toilet trained. Family members and playmates of these children are at high risk of becoming infected. Young children typically shed the organism in their feces for a week or two after their illness resolves. Older children rarely carry the organism without symptoms. Listeriosis Listeria monocytogenes

coli O157:H7.

Found in soft cheese, unpasteurized milk, Onset: From 7-30 days after eating, hot dogs and deli meats, imported seafood but most symptoms have been products, frozen cooked crab meat, cooked reported 48-72 hours after shrimp, and cooked surimi (imitation consumption of contaminated food. shellfish). The Listeria bacteria resist heat, Symptoms: Fever, headache, nausea, salt, and acidity better than many other micro-organisms. They survive and grow at and vomiting. Primarily affects pregnant women and their fetuses, refrigeration temperatures. newborns, the elderly, people with cancer, and those with impaired immune systems. Can cause fetal and infant death. In most instances, caused by failure to keep food hot. A few organisms are often present after cooking and multiply to toxic levels during cool down and storage of prepared foods. Meats and meat products are the foods most frequently implicated. These organisms grow better than other bacteria between 120-130 F. So gravies and stuffing must be kept above 140 F. Raw meats, poultry, eggs, milk and other dairy products, shrimp, frog legs, yeast, coconut, pasta and chocolate are most frequently involved. Onset: Generally 8-12 hours after eating. Symptoms: Abdominal pain and diarrhea, and sometimes nausea and vomiting. Symptoms last a day or less and are usually mild. Can be more serious in older or debilitated people. Onset: Generally 8-12 hours after eating. Symptoms: Abdominal pain and diarrhea, and sometimes nausea and vomiting. Symptoms last a day or less and are usually mild. Can be more

Perfringens food poisoning Clostridium perfringens

Salmonellosis Salmonella bacteria

serious in older or debilitated people. Shigellosis (bacillary dysentery) Shigella bacteria Found in milk and dairy products, poultry, and potato salad. Food becomes contaminated when a human carrier does not wash hands and then handles liquid or food that is not thoroughly cooked afterwards. Organisms multiply in food left at room temperature. Onset: 1-7 days after eating. Symptoms: Abdominal cramps, diarrhea, fever, sometimes vomiting, and blood, pus, or mucus in stool.

Staphylococcal food poisoning Staphylococcal enterotoxin (produced byStaphylococcus aureus bacteria)

Toxin produced when food contaminated Onset: Generally 30 minutes-8 hours with the bacteria is left too long at room after eating. temperature. Meats, poultry, egg products, Symptoms: Diarrhea, vomiting, tuna, potato and macaroni salads, and nausea, abdominal pain, cramps, and cream-filled pastries are good prostration. Lasts 24-48 hours. Rarely environments for these bacteria to fatal. produce toxin. The bacteria live in coastal waters and can infect humans either through open wounds or through consumption of contaminated seafood. The bacteria are most numerous in warm weather. Onset: Abrupt. Symptoms: Chills, fever, and/or prostration. At high risk are people with liver conditions, low gastric (stomach) acid, and weakened immune systems.

Vibrio Infection Vibrio vulnificus

Protozoa Amebiasis Entamoeba histolytica Exist in the intestinal tract of humans and Onset: 3-10 days after exposure. are expelled in feces. Polluted water and vegetables grown in polluted soil spread Symptoms: Severe crampy pain, tenderness over the colon or liver, the infection. loose morning stools, recurrent diarrhea, loss of weight, fatigue, and sometimes anemia. Most frequently associated with consumption of contaminated water. May be transmitted by uncooked foods that become contaminated while growing or after cooking by infected food handlers. Cool, moist conditions favor organism's survival. Onset: 1-3 days. Symptoms: Sudden onset of explosive watery stools, abdominal cramps, anorexia, nausea, and vomiting. Especially infects hikers, children, travelers, and institutionalized patients.

Giardiasis Giardia lamblia

Virus

Calcivirus (Norwalk-like virus, Norovirus)

An extremely common cause of Onset: Generally 24-28 hours after foodborne illness, and the leading exposure. cause of acute gastroenteritis, though rarely diagnosed, because the laboratory Symptoms: Nausea, vomiting, test is not widely available. diarrhea, abdominal pain. Headache and low-grade fever may also accompany this Norwalk-like virus spreads infection. Lasts for 24 to 60 hours. primarily from one infected person to another. Infected persons can contaminate a salad, sandwich or other food as they prepare it if they have the virus on their hands.

Hepatitis A virus

Mollusks (oysters, clams, mussels, scallops, and cockles) become carriers when their beds are polluted by untreated sewage. Raw shellfish are especially potent carriers, although cooking does not always kill the virus.

Symptoms and Onset: Begins with malaise, appetite loss, nausea, vomiting, and fever.

After 3-10 days patient develops jaundice with darkened urine. Severe cases can cause liver damage and death.

Food Safety Glossary The following are some common terms associated with foodborne illness: Bacteria: Living single-celled organisms. They can be carried by water, wind, insects, plants, animals, and people. Bacteria survive well on skin and clothes and in human hair. They also thrive in scabs, scars, the mouth, nose, throat, intestines, and room-temperature foods. Biological hazard: Refers to the danger of food contamination by disease-causing microorganisms (bacteria, viruses, parasites, or fungi) and their toxins and by certain plants and fish that carry natural toxins. Contamination: The unintended presence of potentially harmful substances, including microorganisms in food. Cross-contamination: The transfer of harmful substances or disease-causing microorganisms to food by hands, food-contact surfaces, sponges, cloth towels, and utensils that touch raw food, are not cleaned, and then touch

ready-to-eat foods. Cross-contamination can also occur when raw food touches or drips onto cooked or ready-toeat foods. Foodborne illness: A disease that is carried or transmitted to humans by food containing harmful substances. Examples are the disease salmonellosis, which is caused by Salmonella bacteria and the disease botulism, which is caused by the toxin produced by the bacteria Clostridium botulinum. Food contact surface: Any equipment or utensil that normally comes in contact with food or that may drain, drip, or splash on food or on surfaces normally in contact with food. Examples: cutting boards, knives, sponges, countertops, and colanders. Fungi: A group of microorganisms that includes molds and yeasts. Incidence: The number of new cases of foodborne illness in a given population during a specified period (e.g., the number of new cases per 100,000 population per year). Microorganism: A small life form, seen only through a microscope, that may cause disease. Examples: bacteria, fungi, parasites, or viruses. Outbreak: An incident in which two or more people experience the same illness after eating the same food. Parasite: A microorganism that needs a host to survive. Examples: Cryptosporidium, Toxoplasma. Pathogen: A microorganism that is infectious and causes disease. Spore: A thick-walled protective structure produced by certain bacteria and fungi to protect their cells. Spores often survive cooking, freezing, and some sanitizing measures. Toxins: Poisons that are produced by microorganisms, carried by fish or released by plants. Examples: Botulism caused by the toxin from Clostridium botulinum, scombroid poisoning from the naturally occurring scombroid toxin in some improperly refrigerated fish, such as mackerel and tuna. Virus: A protein-wrapped genetic material which is the smallest and simplest life-form known. Example: Norovirus, hepatitis A.