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FOOD INTOXICATION
Chemical or natural toxin
FOOD INFECTION
Micro organism itself grow inside
produced by micro organism (also called as exotoxin)causes disease Incubation period is shorter Most prevelant symptoms: nausea and vomiting Staphylococcus aureus, Clostridium perfringens, and Clostridium botulinum
the body and causes disease Incubation period is longer Most prevelant symptoms: diarrhea, stomach cramps, fever and chills Salmonella, Enteropathogenic E.coli, Listeria monocytogenes, Shigella, Vibrio parahaemolyticus, Norwalk Viruses, and Hepatitis A
ingested and it grow in body thus causing damage. They are caused by viable, multiplying microorganisms that invade the Gastrointestinal Tract.
ORGANISM
CHARACTERISTIC
SOURCE OF CONTAMINATION
DISEASE
Salmonella
Present in fecal matter in human and animals Gram negative bacteria Facultative anaerobe Optimum growth conditions: pH 4 and 37 degree Celsius.
Escherichia coli
Drinking water and food contaminated with feces. Also, Poultry, eggs, unpasteurized milk. Vegetables grown in fields exposed to Generally Present in Gut Flora sewage, polluted contaminated but enteropathogenic strains irrigation water enter through food Facultative anaerobe Gram Negative rods Produce endotoxins Optimal temperature for growth- 37 degree celsius and pH 4.5-8
Gram negative rod Facultative anaerobe Produce enterotoxins (shiga toxin), a neurotoxin Cannot penetrate the intestinal wall
Shigella
SALMONELLA
Genus: Enterobacteriaceae Species: Salmonella Have 2500 serotypes
Grouped based on on antigenic patters of Somatic antigen (O), Flagellar antigen (H) and Capsular antigen (Vi). Two subspecies : S.enterica and S.bongori Infections caused by salmonella are Enteric Fever ( typhoid and paratyphoid fever) Gastroentritis Septicemia Can be destroyed by ionizing radiation, pasteurization and freezing
Reference - Food Borne Microbial Pathogens by Arun.K.Bhunia, Food science text series, Springer 2008
S.Typhimurium
S.Cholerasius
M cells , dendritic cells and membrane ruffling M cells and dendritic cells
S.Typhi
S.enteritidis
Gastroentritis
Membrane ruffling
ENTERIC FEVER Incubation time 1 week to 1 month Symptoms appear in 1-2 weeks: Continued fever, anorexia, chills,convulsions, Delerium, enlargement of spleen, intestinal ulcers.
GASTROENTRITIS Incubation time 12-24hrs Symptoms appear in 6-24 hrs: Fever, bloody or non bloody diarrhoea, abdominal pain and sometimes vomiting Symptoms persist for 2-3 days
SEPTICEMIA
Symptoms: High fever, chills, rapid breathing and heart rate, red spots on body (petechiae) .
Diagnosis: ELISA, Dot blot immunoassay , Nucleic acid based assays such as RT-PCR can be used for detection. Widal test for is specifically used for detection of typhi and paratyphi. Treatment: Flouroquinolone is most effective. Prevention: Live attenutated Oral Vaccine available Even after treatment can lead to secondary infection. Treatment : It is self limiting hence no antibiotics are given. But to prevent systemic infection chloramphenicol can be given. Treatment: Ampicillin or chloramphenicol
OUTBREAK
Recent outbreak of Salmonella enteritidis From May 1- August 25, 2010 was reported in eggs in the U.S by the Centre of Disease Control and Prevention.
Ref : http://www.cdc.gov/salmonella/enteritidis/
Precautions
A few simple precautions can reduce the risk of food borne diseases:
Hands should be washed before preparing food and people suffering from diarrheal illness should avoid food preparation as this can spread salmonella, shigella , Ecoli. CLEAN: Fresh fruits and vegetables should be rinsed in running tap water to remove visible dirt and grime, Also the outermost leaves of a head of lettuce or cabbage should be discarded. This is because bacteria can grow well on the cut surface of fruit or vegetable. Care should be taken to not contaminate these foods while slicing and the cut produce should be avoided to be left at room temperature for many hours. SEPARATE: Avoid cross-contaminating foods by washing hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch another food. Cooked meat should be put on a clean platter, rather back on one that held the raw meat. COOK :meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160o F. Eggs should be cooked until the yolk is firm. CHILL: Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours. Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration. REPORT: Suspected food borne illnesses should be reported immediately to the local healh department. The local public health department is an important part of the food safety system.
References:
Academic Press,Text book of Food Borne diseases by
Dean.O.Oliver, 1990 Food science text series, Modern Food Microbiology by James.N.Jay, 7th edition Springer 2005 Food Science text series, Food Borne Microbial Pathogens by Arun.k.Bhuniya, Springer, 2008 Tata McGraw Hill Publishing company Limited, Textbook of Microbiology by M.Pelczar, 5th edition, 2005
including bacterially produced exotoxins, which can happen even when the microbe which produced the toxin is no longer present or is not able to cause the infection
Bacterial intoxication: exotoxins produced by bacteria are
MECHANISM OF ACTION
Intake of contaminated food Incubation period delay between intake of contaminated food and appearance of
first symptom of illness Ranges from hours to days depending upon type and quantity of food intake Incubation period of 1-6 hrs shows infection by a bacterial toxin or chemical rather than by live bacteria During the incubation period, microbes pass through the stomach into the intestine, attach to the cells lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a toxin that is absorbed into the bloodstream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe
1. As it grows well in rang e 40140F, so food should be cooled below or heated above this range 2. Keep cuts, sores covered and avoid hand contact with cooked food
Micro organism
Characteris tics
source
symptoms
prevention
Clostridium botulinm
fatigue, dizziness, headache, vomiting, diarrhea, nausea, acute indigestion followed by constipation, vision, difficulty swallowing or speaking. Throat constriction and muscle paralysis come in the final stages, followed by death due to suffocation,
use an approved processing time and temperature when home canning food.
Staphylococcus aureus
Introduction:
Widespread and relatively frequent; one of the principal acute
food intoxications in North America. About 30% of the people are believed to be the carrier of this pathogen bacterial growth may not cause any off color, odor, or textural or flavor change, but the toxin is secreted into the food.
Incubation period: 30 min-8 hrs usually 4-8 hrs
sodium chloride concentrations, so is contained in wide range of food varieties Often this type of food poisoning occurs when cooked food is allowed to cool slowly and/or sit at room temperature for some time. Food at higger risk are those that are prepared by hand and require no cooking like pasteries, pudding, sliced meat etc. Transmitted by cuts, wound on skin. Human and animals are the primary reservoirs
Susceptibility:
routine culture media or detection of enterotoxin from epidemiologically implicated food item confirms the diagnosis heat killed staphylococci in the food can be confirmed by gram stain of the heated food Isolation of organisms of the same type by pulsed field gel electrophoresis from stools of two or more ill persons also confirms the diagnosis
Control:
Supportive therapy and fluid replacement may be provided
when required
cleanliness of kitchens, proper temperature control, hand washing, cleaning of fingernails and the danger of working with the exposed skin, nose and eye infections and the need to cover wounds. reduce food handling time to an absolute minimum, with not more than 4 hrs at ambient temperature Keep perishable foods hot (> 60C) or cold (< 4C) in shallow containers and covered, if they are to be stored for more than 2 hrs. Temporarily exclude people with boils, abcesses and other purulent lesions of hands, face or nose from food handling.
OUTBREAK
One outbreak of staph food poisoning occurred at a convention
in Chicago . A banquet meal included ham, potato salad, baked beans, rolls, chocolate cake and assorted drinks. Six hours after the meal, about one-third of the conventioneers developed cases of staph food poisoning. When the foods served were examined, the ham was found to be highly contaminated with staph bacteria. CAUSE: The ham had been baked the day before and refrigerated overnight. The next day, a cook with an infected cut on his
layers,wrapped in aluminum foil, warmed and held for several hours before serving.
ERRORS AND PREVENTIONS: First, the employee with the infected cut should have cleaned and covered it with a bandaid and glove. Second, the contaminated slices should not have been piled in layers but spread so the heat could have penetrated and killed the bacteria. Third, the sliced ham should not have been heated until just before serving, eliminating time for bacterial growth. It should have been held hot, above 140 degrees F, which would have prevented bacterial growth.
REFERENCES
Estes Reynolds, George Schuler, William Hurst & P.T. Tybor, Preventing
food poisoning and food infection, The University of Georgia College of Agricultural & Environmental Sciences Communicable disease management protocol, staphyloccocus food intoxication Text book of Food Borne diseases by Dean.O.Oliver, Academic Press, 1990