Microbiology, Allergies and Nutrition

Andreia Couto
2010/2011

Lecture n 7

Escola de Hotelaria e Turismo do Algarve

COMMON PATHOGENS Campylobacter

INCUBATION PERIODS
2 to 7 days (usually 3 to 5 days)

COMMON SYMPTOMS
Diarrhea (often bloody), abdominal cramps, nausea and headaches. Typically resolves within 1 to 10 days. Nausea and diarrhea. Typically resolves within 24 to 48 hours. Diarrhea (often bloody), abdominal cramps and vomiting; usually no fever. HUS may develop in rare cases. Typically resolves within 1 to 8 days (in non-complicated cases) Diarrhea, abdominal cramps and vomiting; usually no fever. Typically resolves within 1 to 2 days.

Bacillus Cereus E. coli O157:H7

1-6 hrs (vomiting) 6 24 hrs (diarrhea) 24+ hrs to 10 days (usually 3 to 4 days) 8 to 22 hrs (average is 12 hrs)

C. Perfringins

Hepatitis A

15 to 50 days (average is 28 days)

Diarrhea, dark urine, jaundice and flu-like symptoms, including headaches, fever, nausea and abdominal pain. Duration is variable (ranging a few weeks to 3 months).
2

Listeria

9-48 hrs (for GI symptoms) 2 to 6 weeks (for invasive disease)

Fever, muscle aches, nausea, diarrhea; pregnant women may suffer flu-like symptoms and stillbirth; elderly, immune-compromised and infants can develop sepsis and meningitis. Duration is variable.

Norovirus

12 to 72 hrs (usually 24 to 48 hrs)

6 to 72 hrs (usually 12 -36 hrs)

Diarrhea, abdominal cramps, vomiting, headaches and fever. Typically resolves within 1 to 3 days.
Diarrhea, abdominal cramps, nausea, vomiting and fever. Typically resolves within 4 to 7 days.

Salmonella

Shigella

24 to 72 hrs (usually 36 to 48 hrs)

Watery diarrhea, nausea, vomiting, abdominal cramps, chills and fever. Stool may contain blood and mucus. Typically resolves within 4 to 7days.
Diarrhea, abdominal cramps, nausea and vomiting. Typically resolves in 24 to 48 hrs. Nausea, vomiting, diarrhea, fatigue, headache, dry mouth, double vision, muscle paralysis, respiratory failure. Duration is variable (days to months).

Staphylococcus

30 minutes to 8 hrs (usually 2 to 4 hrs) 12 to 72 hrs (usually 18 to 36 hrs)

C. Botulinum

CLOSTRIDIUM BOTULINUM Because of its severity and distinctive symptoms, botulism is the form of bacterial food poisoning for which we have the earliest reliable reports. The cells are Gram-positive, motile with peritrichous flagella, obligatory anaerobic, straight or slightly curved rods 2-10 pm long, and form central or subterminal oval spores. Strains of C. botulinum display sufficient variety of physiological and biochemical characteristics to be inconsistent with their inclusion in a single species.

They are strongly proteolytic and will often betray their presence in food by partial disintegration of the product and a slight rancid or cheesy odor. Unfortunately despite these warning signs the potency of the toxin is such that the amount ingested on sampling the food has often proved sufficient to cause illness. The minimum pH at which C. botulinum will grow depends very much on factors such as temperature, water activity and the acid used to adjust the pH. The consensus has long been that a pH around 4.7 represents an absolute minimum and this fact has had important practical implications for the canning industry.

Botulism is an example of bacterial food poisoning in its strictest sense: it results from the ingestion of an exotoxin produced by Clostridiurn botulinum growing in the food. The botulinum toxins are neurotoxins; unlike enterotoxins, which act locally in the gut, they affect primarily the cholinergic nerves of the peripheral nervous system. Initial symptoms of botulism occur anything from 8 h to 8 days, most commonly 12-48 h, after consumption of the toxin-containing food.

Symptoms include vomiting, constipation, urine retention, double vision, difficulty in swallowing (dysphagia), dry mouth and difficulty in speaking (dysphonia).

The patient remains conscious until, in fatal cases, shortly before the end when the progressive weakness results in respiratory or heart failure. This usually occurs 1-7 days after the onset of symptoms. Surviving patients may take as long as 8 months to recover fully. The botulinum toxins are the most toxic substances known, with a lethal dose for an adult human in the order of 10-8 g.

Four common features are discernible in outbreaks of botulism: (1) The food has been contaminated at source or during processing with spores or vegetative cells of C. botulinum. (2) The food receives some treatment that restricts the competitive microflora and, in normal circumstances, should also control C. botulinum. (3) Conditions in the food (temperature, pH, aW) are suitable for the growth of C. botulinum. (4) The food is consumed cold or after a mild heat treatment insufficient to inactivate toxin.

The list of foods commonly contaminated are vegetables like canned corn, peppers, green beans, soups, beets, asparagus, mushrooms, ripe olives, stuffed eggplant and spinach. Seafood and meat items include tuna fish, lobster, smoked and salted fish, chicken and chicken livers, liver pate, luncheon meats, ham and sausage. Apart from canning, vacuum sealing is another type of food packaging that may also harbor botulism. By wrapping food tightly in plastic, oxygen is removed, which allows bacteria to grow. This is common with vegetables and is the reason why supermarkets use loose packaging to let in oxygen.

Shigella
Shigella are Gram-positive, nonmotile, nonsporeforming rod-shaped bacteria. Shigella bateria were discovered over 100 years ago by a Japanese scientist named Shiga, for whom they are named. Currently, Shigella (shigellosis) accounts for approximately 10% of reported food-borne illness in the United States. In addition to person to person transmission (through the fecal-oral route), Shigella may also be acquired from eating contaminated food, or by drinking or swimming in contaminated water.

Incriminating foods have included salads (potato, tuna, shrimp, macaroni, and chicken), raw vegetables, milk and dairy products, and poultry.

10

Shigella are highly infectious, and a relatively small number of organisms can cause illness. In turn, illness is caused when Shigella organisms are consumed and then attach to and penetrate the epithelial cells of the intestinal mucosa.

After invasion, the bacteria multiply and spread to contiguous cells resulting in tissue destruction. Some strains produce enterotoxin and Shiga toxin (similar to the verotoxin of E. Coli O157:H7). Symptoms include abdominal pain, cramps, diarrhea, fever, vomiting and/or blood or mucus in stools. Symptoms typically occur between 36 and 48 hours after the consumption of contaminated food, and will typically resolve within 4 to 7 days.

As with other common food-borne pathogens, the spread of Shigella can be prevented by frequent and careful handwashing with soap.
11

Food Allergies
Allergy is a hypersensitive disorder of the immune system. Allergic reactions occur to normally harmless environmental substances known as allergens; these reactions are acquired, predictable, and rapid. Eight foods account for 90 percent of all food-allergic reactions. They are milk, egg, peanut, tree nuts, fish, shellfish, soy, and wheat. Some of these allergens may be outgrown, but others, such as peanut and shellfish, will remain lifelong allergies.

12

One of the most common food allergies is a sensitivity to peanuts. Peanut allergies may be extremely severe, but can sometimes be outgrown by children school-age. Tree nuts, including pecans, pistachios, pine nuts, and walnuts, are another common allergen. Sufferers may be sensitive to one, or many, tree nuts. Also seeds, including sesame seeds and poppy seeds, contain oils where protein is present, which may elicit an allergic reaction. Egg allergies affect about one in fifty children but are frequently outgrown by children when they reach age five. Typically the sensitivity is to proteins in the white, rather than the yolk.

13

Milk allergy
Milk allergy is one of the most common food allergies in children. Although cow's milk is the usual cause of milk allergy, milk from sheep, goats and buffalo also can cause a reaction. And, some children who are allergic to cow's milk are allergic to soy milk too. A milk allergy usually occurs a few minutes to a few hours after you consume milk. Signs and symptoms of milk allergy range from mild to severe and can include wheezing, vomiting, hives and digestive problems. Rarely, milk allergy can cause anaphylaxis a severe, life-threatening reaction.

14

Milk allergy symptoms differ from person to person and occur within a few minutes to a few hours after ingesting milk. Immediately after consuming milk, signs and symptoms of a milk allergy might include:

Hives Wheezing Vomiting Signs and symptoms that may take more time to develop include: Loose stools, which may contain blood Diarrhea Abdominal cramps Coughing or wheezing Runny nose Watery eyes Itchy skin rash, often around the mouth Colic, in babies
15

Milk allergy or milk intolerance? It's important to differentiate a true milk allergy from milk protein intolerance or lactose intolerance. Unlike a milk allergy, intolerance doesn't involve the immune system. Milk intolerance causes different symptoms and requires different treatment than does a true milk allergy. Common signs and symptoms of milk protein or lactose intolerance include digestive problems, such as bloating, gas or diarrhea, after consuming milk or products containing milk.

16

Egg allergy
Eggs are one of the most common allergy-causing foods, especially in children. However, most children eventually outgrow their egg allergy. An egg allergy usually occurs a few minutes to a few hours after eating eggs or foods containing eggs. Signs and symptoms range from mild to severe and can include skin rashes, hives, vomiting or inflamed nasal passages. Rarely, egg allergy can cause anaphylaxis a severe, life-threatening reaction. The key to preventing an egg allergy is avoiding eggs and foods that contain eggs. This can be a challenge because eggs are a common food ingredient.

17

Egg allergy symptoms differ from person to person and occur within a few minutes to a few hours after exposure to eggs. Egg allergy symptoms can include:

Skin inflammation or hives, the most common egg allergy reaction Allergic asthma

Allergic nasal inflammation (rhinitis)

Gastrointestinal symptoms, such as cramps, nausea and vomiting

18

Anaphylaxis Egg allergy can cause anaphylaxis, a life-threatening reaction that can block the airways and breathing. Anaphylaxis is a medical emergency and requires treatment with an epinephrine (adrenaline) shot and a trip to the emergency room. Signs and symptoms start soon after eating eggs and can include:

Constriction of airways, including a swollen throat or a lump in your throat that

makes it difficult to breathe

Shock, with a severe drop in blood pressure Abdominal pain and cramping Rapid pulse Dizziness, lightheadedness or loss of consciousness

19

Peanut allergy
Peanut allergy is common, especially in children. Peanut allergy symptoms can range from a minor irritation to a life-threatening reaction (anaphylaxis). For some people with peanut allergy, even tiny amounts of peanuts can cause a serious reaction.

Peanut allergy is one of the most common causes of severe allergy attacks. It's important to get even a minor reaction to peanuts checked out.

20

An allergic response to peanuts usually occurs within minutes after exposure, and symptoms range from mild to severe. Peanut allergy symptoms can include:

Skin reactions such as hives, redness or swelling Itching or tingling in or around the mouth and throat

Digestive problems such as diarrhea, stomach cramps, nausea or vomiting

Tightening of the chest Shortness of breath or wheezing Runny or stuffy nose

21

Anaphylaxis Peanut allergy is one of the most common causes of anaphylaxis, a medical emergency that requires treatment with an epinephrine (adrenaline) injector (EpiPen, EpiPen Jr or Twinject) and a trip to the emergency room. Anaphylaxis signs and symptoms can include:

Constriction of airways Swelling of your throat that makes it difficult to breathe A severe drop in blood pressure (shock) Rapid pulse Dizziness, lightheadedness or loss of consciousness

22

Tree nut allergy

Tree nut allergy is one of the most common food allergies in children and adults. Like peanuts, tree nuts (almonds, cashews, walnuts, etc.) tend to cause particularly severe reactions, even if a person is exposed to only a tiny amount. Many experts advise patients allergic to tree nuts to avoid peanuts and other tree nuts because of the high likelihood of cross-contact at processing facilities, which process peanuts and different tree nuts on the same equipment. Further, a person with an allergy to one type of tree nut has a higher chance of being allergic to other types.

23

Probably the most common tree nuts allergy is a skin irritation. The area may feel hot and a red rash may develop. Some people will break out in hives on their back and experience swelling in the face. The area may be extremely itchy as well, especially around the mouth. Feeling sick to your stomach, throwing up, and even diarrhea can also result from this type of allergic reaction. For some people their heart is affected, and it can cause cardiac arrest. Arrhythmia is also possible which means that the heart is beating irregularly. It may be too fast or too slow but either way it isnt healthy for you. The symptoms of tree nuts allergy can be very severe so a person needs to not take any chances when they find out they are allergic to them. Getting the treatment that is available as soon as they have been exposed is also very important.

24

Soy allergy
Soy, a product of soybeans, is one of the common foods that can cause allergies.

In most cases signs and symptoms of soy allergy are mild. In rare cases, soy allergy can cause a life-threatening allergic reaction (anaphylaxis). You can reduce your risk of having an allergic reaction to soy by knowing as much as you can about soy allergy and how to avoid soy-containing products.

25

For most people, soy allergy is uncomfortable but not serious. Rarely, an allergic reaction to soy can be frightening and even life-threatening. Signs and symptoms of a food allergy usually develop within a few minutes to an hour after eating soycontaining food. Soy allergy symptoms can include: Tingling in the mouth

Hives, itching or eczema

Wheezing, runny nose or trouble breathing Abdominal pain, diarrhea, nausea or vomiting Dizziness, lightheadedness or fainting Swelling of the lips, face, tongue and throat, or other parts of the body

26

A severe allergic reaction to soy called anaphylaxis is rare. It's more likely to occur in people who have asthma or are also allergic to other foods such as peanuts. As mentioned previously anaphylaxis causes more extreme signs and symptoms.

27

Shellfish allergy
Shellfish allergy is one of the most common food allergies. If you have a shellfish allergy, you may have an allergic reaction to only certain kinds of shellfish, or you may have an allergy to all shellfish. Shellfish include marine animals with shells, such as clams, lobster and shrimp, as well as octopus and squid. Shellfish allergy can cause mild symptoms, such as hives or nasal congestion, or more-severe and even life-threatening symptoms. For some people, even a tiny amount of shellfish can cause a serious reaction.

28

Shellfish allergy symptoms include:

Hives, itching or eczema Swelling of the lips, face, tongue and throat, or other parts of the body Wheezing, nasal congestion or trouble breathing Abdominal pain, diarrhea, nausea or vomiting Dizziness, lightheadedness or fainting

Tingling in the mouth

A severe allergic reaction to shellfish (anaphylaxis) is rare but can be lifethreatening if it interferes with your breathing.
29

Wheat allergy
Wheat allergy is an abnormal immune system reaction to one or more proteins found in wheat. Allergy to wheat is one of the more common food allergies. If you have wheat allergy, you will likely experience symptoms within a few minutes to a few hours after eating something containing wheat. Wheat allergy symptoms include: Swelling, itching or irritation of the mouth or throat Hives, itchy rash or swelling of the skin Nasal congestion Itchy, watery eyes Difficulty breathing Cramps, nausea or vomiting Diarrhea Anaphylaxis
30

Anaphylaxis caused by wheat allergy For some people wheat allergy may cause a life-threatening reaction called anaphylaxis. In addition to other signs and symptoms of wheat allergy, anaphylaxis may cause: Swelling or tightness of the throat Chest pain or tightness Severe difficulty breathing Trouble swallowing Pale, blue skin color Dizziness or fainting

Weak pulse

31

Fish allergy
Fish allergies are similar to shellfish allergies in that they are more likely than many food allergies to start during adulthood and less likely than other allergies to be outgrown. While fish is easier than many other allergens to avoid, fish allergies are often quite severe.

People who are allergic to one type of fish, such as cod, often react to other types of fish such as hake, haddock, mackerel and whiting as well. This is because the allergens in these fish are quite similar. Cooking doesn't destroy fish allergens. In fact, some people with fish allergy can be allergic to cooked but not raw fish.

32

Fish allergy is linked to an increased risk of severe asthma in adult patients. Fish has been linked with the oral allergy syndrome (in which the mouth itches or tingles after eating an allergen) in people with occupational contact with fish. The greatest risk from fish allergies is anaphylaxis.

There is high allergic cross-reactivity among different types of fish, meaning that people with allergies to one type of fish are likely to have (or to develop) allergies to others. This is because of a protein (parvalbumin) that is present in many fish. For this reason, most people with an allergy to one fish are advised to avoid all fish (including eel and shark). Some fish--specifically tuna and mackerel--are considered less allergenic than others.

33

34