Incidence And Impact Of Foodborne Diseases Flashcards
How many cases of childhood diarrheal disease occur annually
1.7 billion
How many children under 5 die from diarrheal disease each year
525,000
General cause of childhood diarrheal disease
Food borne illness
CDC estimates for people sick, hospitalized and dead from food borne diseases each year in U.S.
Sick = 48 million
Hospitalized = 128,000
Dead = 3,000
What book stimulated passage of meat inspection act and pure food and drug act
The jungle by upton Sinclair
5 opportunities for contamination
-production
-processing
-consumption
-retail
-distribution
Microorganisms grow best at (pH, temperature, time, moisture)
-pH between 4.6-7.5
-within temperature danger zone of 40-140F
-time >4 hours
-moist environment (water activity greater than 0.85)
Foodnet: general
Surveillance network
Monitors 8 pathogens in 10 U.S. states (15% of U.S. population)
Collaboration between CDC, USDA and FDA
4 objectives of FoodNet
- Determine the burden of foodborne illness in the United States
- Monitor trends in specific foodborne illness over time
- Attribute foodborne illnesses to specific foods and settings
- Develop and assess interventions to reduce foodborne illnesse
Top 8 food borne pathogens in foodnet (rank 1-10)
- Campylobacter
- Salmonella
- Escherichia coli
- Shigella
- Yersinia
- Vibrio
- Cyclospora
- Listeria
Most common source of food borne illness outbreaks from food preparation
Restaurants
Most common food commodity as source of food borne illness outbreaks
Mollusks
Largest contributor to outbreak associated illness from 2009-2018
Plants (34%)
2021 incidence of infections caused by food borne pathogens in 10 U.S. states (# infections, hospitalizations, deaths): FoodNet
Infection = 22,000
Hospitalizations = 5,000
Deaths = 150
Trends in infections caused by food borne pathogens (3)
-underreported
-infection rates mostly unchanged during past 2 decades, but increasing for some food borne pathogens
-produce still major source of food borne illness
number of illnesses and hospitalizations from food borne illnesses related to dairy productions consumption (per year)
760 illnesses
22 hospitalizations
What percent of total illnesses and hospitalizations was due to consumption of unpasteurized milk and cheese (From a study)
95%
Top factors in newly emerging foodborne illnesses (3)
• Human demographics & behavior - Aging population, Higher consumption of fresh fruits & vegetables , ‘Organic’ doesn’t mean safer ,More food consumed outside the home
• Technologies within the food industry - Food transported over longer distances, Larger production facilities, Point source contamination has greater impact
• International travel & commerce - ‘Traveler’s diarrhea’; Travelers often take food with them on trip
Other factors in newly emerging foodborne illnesses (3)
-microbial adaptation
-economic development and land use
-shortfalls in public health education
Infections definition: foodborne illness
• Pathogen enters the body and must grow to cause effect
• Can be bacterial, viral, parasitic, or fungal
• Typically have longer incubation periods and cause fever
Intoxications definition: foodborne illness
• Preformed toxin enters the body and directly exerts effect
• Most foodborne toxins are bacterial in origin (but not all)
• Typically have shorter ‘incubation’ periods; not as
pyrogenic
Major foodborne pathogens (10)
-bacillus cereus
-campylobacter jejuni
-clostridium botulinum
-clostridium perfringens
-enterohemorrhagic E. Coli
-hepatitis A
-listeria monocytogens
-norovirus
-salmonella enteric a
-staphylococcus aureus
Salmonella: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.
type of organism - gram negative bacteria
commonly implicated food(s) - raw/imported pasteurized milk, raw meats and poultry, eggs
source of infection - domestic and wild animals (nontyphoidal), humans (typhoidal)
infection vs. intoxication- INFECTION
incubation period - 6-72 hours (GI), 1-3 weeks (typhoidal)
major symptoms (GI type/nontyphoidal) = nausea, vomiting, cramps, fever, diarrhea
Major symptoms (typhoidal) = very high fever, lethargy, RASH OF FLAT, ROSE COLORED SPOTS
major control measures - cook food thoroughly, hygiene during food handling, hand washing
Nontyphoidal serotypes for salmonella
Zoonotic
Typhoidal serotypes of salmonella
Humans only
Only know reservoir for salmonella enteric typhoidal and Paratyphi
Humans
What percent of all raw poultry samples culture positive for salmonella
33%
Campylobacter jejuni: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures
type of organism - gram negative non spore forming bacteria
commonly implicated food(s) - raw poultry, raw milk and cheeses, WATER
source of infection - normal gut flora of most food producing animals (contaminates food and water)
infection vs. intoxication - INFECTION
incubation period - 2 to 5 days
major symptoms - fever, nausea, water/sticky diarrhea with maybe blood, miscarriage or still birth, Gillian barre syndrome
major control measures - hygienic slaughter, prevent cross contamination, refrigeration, don’t consume unpasteurized products
How many pathogenic types of e. Coli are there
6
Enterohemorrhagic Escherichia coli: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.
type of organism - gram negative bacteria
commonly implicated food(s) - ground meats, raw milk, juices, fresh veggies, apple cider, yogurt, mayo
source of infection - CATTLE, ruminants
infection vs. intoxication - SHIGA TOXIN formed after ingestion of bacteria (not preformed)
incubation period - 3 to 4 days
major symptoms - hemorrhagic colitis (severe cramps, water to bloody diarrhea), hemolytic uremic syndrome in children
major control measures - cook ground beef well, don’t consume unpasteurized, hand washing
Listeria monocytogenes: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.
type of organism - gram positive bacteria (can grow in freezing temperatures!!!!)
commonly implicated food(s) - raw milk, soft cheese, seafood, deli meats, raw veggies
source of infection - livestock food and silage, handling and slaughter operations (causes neurologic disease in livestock)
infection vs. intoxication - infection
incubation period - hours to 3 days (GI), 3 days to 3 months (invasive)
major symptoms - fever, nausea, vomiting (GI); stiff neck, confusion, loss of balance, abortions/stillbirths (invasive form)
major control measures - NO RAW milk or dairy products from raw milk, no ready to eat foods, wash fresh fruits and veggies, cook meat
Number of deaths from listeriosis is what % of all foodborne illness deaths
28
Clostridium perfringens: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures
type of organism - gram positive spore forming bacteria
commonly implicated food(s) - beef and poultry, Mexican foods, veggies
source of infection - found in soil, contaminated by human or animal feces
infection vs. intoxication - ENTEROTOXIN formed in intestine after ingestion
incubation period - 16 hours (FAST)
major symptoms - water diarrhea, highly fatal form called pig bel disease
major control measures - refrigerate or eat foods soon after cooking, wash fruits and veggies
pigbel disease form of clostridium perfringens: cause, effect, common in what country
Necrotizing enteritis
Contaminated pork
More common in Papa New Guinea
What percent of people are healthy carriers for staphylococcus aureus
25
Bacillus cereus: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.
type of organism - gram positive spore forming bacteria
commonly implicated food(s) - rice (vomiting type), many foods for diarrhea type
source of infection - soil, fecal oral contamination, bad hygiene, cross contamination
infection vs. intoxication - INTOXICATION (vomiting type toxin is heat stable, diarrhea type is heat labile/susceptible)
incubation period - 30 min to 6 hours (vomiting type), 6 to 15 hours (diarrhea type)
major symptoms - nausea and vomiting (vomiting type), water diarrhea, abdominal pain, cramping (diarrhea type)
major control measures - refrigeration, reheat foods thoroughly
2 types of bacillus cereus
Vomiting
Diarrheal
Clostridium botulinum: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.
type of organism - gram positive
commonly implicated food(s) - low oxygen foods (canned foods), honey
source of infection - agricultural products (meats, produce, honey, fish), spores everywhere
infection vs. intoxication - INTOXICATION, neurotoxin formed by bacterial phase
incubation period - 18 to 26 hours after ingestion of preformed toxin
major symptoms - double or blurred vision, slurred speech, difficulty swallowing, muscle weakness, infant botulism
major control measures - boil canned foods for 10 minutes before eating, process foods below pH 4.6, don’t feed honey to infant
Infant botulism: cause, symptoms
Caused by honey
Constipation is first sign
Flat facial expression, weak cry
What is the most lethal natural neurotoxin known
From clostridium botulinum
How can you inactivate spores from clostridium botulinum
Boil for more than 5 minutes
Hepatitis A: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.
type of organism - RNA virus
commonly implicated food(s) - person to person, contaminated water/shellfish
source of infection - feces of infected people (fecal oral route of transmission)
infection vs. intoxication - INFECTION
incubation period - 30 days average (LONG)
major symptoms - asymptomatic in children, initially have fever/nausea, jaundice days later
major control measures - wash hands, hepatitis A vaccine
case fatality rate of hepatitis A
2.4
Norovirus: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.
type of organism - RNA virus
commonly implicated food(s) - any food prepared by infected person, shellfish grown in infected water
source of infection - humans, contaminated water
infection vs. intoxication - INFECTION
incubation period - 24 to 28 hours (maybe 12 hours)
major symptoms - recover in few days, explosive vomiting, headache, chills, 30% show no signs
major control measures - hand washing, food handling
What is the leading cause of disease outbreaks from contaminated food in the U.S (called the winter vomiting bug or 24 hour flu)
Norovirus
Which 2 pathogens have very low case fatality rates
Listeria monocytogenes
Salmonella enterica