Food borne Illness

Question 1

Gastroenteritis

Answer 1

> 3 episodes of diarrhea and/or vomiting in a 24 hour period AND duration of symptoms <7days!!!!

Question 2

Viral Infections for Gastroenteritis

Answer 2

target small intestine which causes watery diarrhea, and vomiting!!! Can have post-infection lactose intolerance because of effects on brush border of small intestines…

Question 3

Bacterial Infections for Gastroenteritis

Answer 3

Usually target large intestine and colon! Can cause bloody diarrhea with mucous = invasive. Can also be non-invasive which has non-bloody diarrhea but in small volume. Remember because water is all absorbed by time it gets to large intestine… less water! Thsu watery is for small intestine which is Viral! BUT cholera has large volume! But generally less vomiting.

Question 4

Pre-formed Bacterial Toxin mediated gastroenteritis?

Answer 4

its like a time bomb! VERY short incubation time before symptoms start! Symptoms start in less than 6 hours!

Question 5

Shortest to longest incubation of: Bacillus Cereus Diarrheal Illness, Staphylococcus Aureus, Bacillus Cereus Emetic Illness, Clostridium perfringens?

Answer 5

• Staphylococcus aureus
• Bacillus cereus Emetic illness (since vomitting will happen before diarrhea!)
• Bacillus cereus Diarrheal illness
• Clostridium perfringens
  (ABC!)

Question 6

Food poisoning from food contaminated with STAPHYLOCOCCUS AUREUS

Answer 6

Pre-formed toxins (enterotoxins) that are resistant to heat treatment, low pH, and proteolytic enzymes. Staph. is quite RESISTANT TO SALT!

- Onset: 1-6 hours
- Signs/s: Sudden onset of severe nausea and vomiting, cramps, and some diarrhea and fever
- Duration: 1-2 days
- Common Source: Unrefrigerated meats, potato, egg salads, and cream pastries

Question 7

Food poisoning from food contaminated with BACILLUS CEREUS

Answer 7

Two syndromes:

1. Emetic illness... caused by pre-formed emetic toxin cereulide which is resistant against heat, acids, and proteolysis. SPORES RESISTANT TO HEAT AND DESICCATION.
	- Onset: 1-6 hours
	- Signs/s: More vomiting than diarrhea
	- Duration: 9 hours
	- Common Source: Fried rice

2. Diarrheal Illness... not pre-formed! Takes longer! Bacteria multiply in intestine.
	- Onset: 6-14 hours
	- Signs/s: Cramps, watery diarrhea, nausea
	- Duration: 1-2 days
	- Common Source: Meats, stews, gravies, vanilla sauce, cream baked food

Question 8

Food poisoning from food contaminated with Clostridium Perfringens

Answer 8

Occurs when resistant spores of toxin-producing strains survived improper cooking then germinate into vegetavely growing cells in high numbers in the contaminated food. Some ingested bactera can survive pH of stomache then multiple in intestine and commit to sporulation, they release entertoxin when during SPORULATION.

- Onset: 8-16 hours
- Signs/s: Intense abdominal cramps, watery diarrhea
- Duration: 1 day
- Common Source: Meats, poultry, gravy, dried or precooked foods, time/temp abused foods.

Question 9

Gastroenteritis MAIN transmission pathway:

Answer 9

Fecal-Oral

Question 10

EHEC E.Coli…The UGLY

Answer 10

• Produce toxins stx1 and stx2, shiga toxin
  
  • Most famous strain: E COLI 0157:H7.. this is usually only strain tested in lab!
  • Hemolytic Uremic Syndrome… developing with 2-12 days..the young and old.
  • Bacteria is on the SURFACE of every small piece of meat… Don’t give antibiotics to those with bloody diarrhea with EHEC!!!!!** Hamburger disease!

Question 11

Sheila… The loving and infectious!

Answer 11

• Infectious dose is only 100 bacteria.. it is ETEC!
  
  • Traveller’s diarrhea
  • high fever, initially watery diarrhea then followed by bloody diarrhea.
  • USE antibiotics for shigellosis.

Question 12

Salmonella… The Animal Loving and Large Family

Answer 12

Many serotypes! Has typhoidal and non-typhoidal types.

- Common sources(THREE TYPES): eggs, poultry, meat, unpasteurized milk or juice. OR reptiles (pets)! And Travel history to endemic areas!
- In young children... If babies might have meningitis
- Typhoid Mary.. loved cocaine. Was a carrier!

Question 13

Campylobacter… The common but special Campy

Answer 13

• Very common cause of gastroenteritis
• Jejuni most common
  
  • Special Feature: Post-infectious immunoreactive syndromes. Antibodies attack motor neurons in spinal chord!
  • Source: Raw and undercooked poultry, unpasteurized milk, contaminated water
  • Non bloody or bloody diarrhea, cramping, abdominal pain, and fever
  • Supportive treatment only.

Question 14

Listeria monocytogenes… the Notorious

Answer 14

• Can grow very well at fridge temperature.
  
  • Source: unpasteurized milk, soft cheeses, deli meats.
  • Affects different individuals differently!
    
    • Healthy: asymptomatic infection or mild gastroenteritis
    • Elderly/immunocompromised - bacteremia, meningitis, encephalitis
    • Pregnant women - stillborn, neonatal infection (won’t affect mom.. but would affect baby!)

Question 15

Vibrio Cholerae… The secretory one

Answer 15

• Endemic and epidemic disease!
• Range from moderate to severe!
• Toxin that acts on small bowel! with Na and Chloride secretion causes watery colorless diarrhea with mucous.. rice water stools!
• HIGH volume fluid loss! Electrolytes imbalance, hypoglycemia!
• Management - fluid replacement and antibiotics!

Question 16

Norovirus… The smallest but powerful one

Answer 16

• Non-enveloped RNA virus!
• Famous with cruise ship outbreaks
• Most common virus that causes sporadic gastroenteritis
• 1-2 day incubation.. but only last 1-3 days!.. Winter Vomiting Illness
• Supportive management
• Virus that changes!
• Vaccine in development!

Question 17

What do you do when you see someone with suspected acute gastroenteritis?

Answer 17

• History and physical
  
  • History:
    Gastroenteritis
    -Physical:
    -Basic A B C
    
    • Systemic signs
      Diagnostic tests for Gastroenteritis… Enteric bacteria culture, viruses .. electron microscopy. WASH HANDS!