Food Contamination/Poisoning



Foodborne disease is extremely costly. Health experts estimate that the yearly cost of all foodborne diseases in this country is 5 to 6 billion dollars in direct medical expenses and lost productivity.

There are more than 250 known foodborne diseases. They can be caused by bacteria, viruses, or parasites. Natural and manufactured chemicals in food products also can make people sick. Some diseases are caused by toxins (poisons) from the disease-causing microbe (germ), others by the human body's reactions to the microbe itself.

Campylobacteriosis

Campylobacteriosis is an infectious disease caused by eating or handling contaminated food or drinking contaminated beverages. Health care providers report more than 10,000 cases to the Centers for Disease Control and Prevention (CDC) yearly, of which about 100 people die. It occurs more frequently in summer than winter.

    Cause

    Campylobacteriosis is caused by bacteria called Campylobacter. Campylobacter jejuni, C. fetus, and C. coli are the types that usually cause the disease in people. C. jejuni causes most cases of this foodborne disease. According to CDC, C. jejuni is the leading cause of bacterial diarrheal illness in the United States, affecting about 2.4 million people every year. The bacteria cause between 5 and 14 percent of all diarrheal illness worldwide. C. jejuni primarily affects children less than 5 years old and young adults (15 to 29 years old).

    Transmission

    You can get infected with Campylobacter from handling raw poultry, eating undercooked poultry, drinking nonchlorinated water or raw milk, or handling infected human or animal feces. Most frequently, poultry and cattle waste are the sources of the bacteria, but feces from puppies, kittens, and birds also may be contaminated with the bacteria.

    Symptoms

    If you are infected with Campylobacter, you may have no symptoms. If you do, they can include Campylobacteriosis usually lasts for 2 to 5 days, but in some cases as long as 10 days. Rarely, some people have convulsions with fever or meningitis (inflammation of the lining of the spinal cord).

    Diagnosis

    Your health care provider can use laboratory tests to identify Campylobacter in your stool if you are infected.

    Treatment

    If you are like most people infected with Campylobacter, you will get better with no special treatment. If you need treatment, your health care provider can prescribe an antibiotic such as ciprofloxacin or azithromycin. Erythromycin helps treat diarrhea caused by Campylobacter. If you have diarrhea, be sure to drink plenty of water.

    Prevention

    If you are infected with Campylobacter, you may have no symptoms. If you do, they can include
      Wash hands before preparing food.
      Wash hands immediately after handling raw poultry or other meat.
      Nausea and vomiting
      Wash thoroughly with soap and hot water all food preparation surfaces and utensils that have come in contact with raw meat.
      Cook poultry products to an internal temperature of 170 degrees Fahrenheit for breast meat and 180 degrees Fahrenheit for thigh meat. Don't drink unpasteurized milk and water that isn't chlorinated or boiled.
      Wash hands after handling pet feces or visiting petting zoos.
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    Foodborne Botulism

    Botulism is a rare but serious illness. Each year, U.S. health care providers report an average of 110 cases of food, infant, and wound botulism to Centers for Disease Control and Prevention (CDC). About 10 to 30 outbreaks of foodborne botulism are reported annually. Although this illness does not occur frequently, it can be fatal if not treated quickly and properly. This fact sheet will focus on botulism caused by eating contaminated food.
      Cause

      Botulism is caused by toxin produced by Clostridium botulinum bacteria. This toxin affects your nerves and, if untreated, can cause paralysis and respiratory failure. C. botulinum toxin is one of the most powerful toxins known in nature. Exposure to the toxin, particularly in an aerosolized (spray) form, can be fatal. C. botulinum has been made into weapons by rogue states and is a focus of current efforts to counter bioterrorism.

      Transmission

      Often, cases of foodborne botulism come from home-canned foods with low acid content, such as asparagus, green beans, beets, and corn. C. botulinum is anaerobic, which means it can survive and grow with little or no oxygen. Therefore, it can live very well in sealed containers. Outbreaks of the infection, however, are often from more unusual sources such as chili peppers, tomatoes, and improperly handled baked potatoes wrapped in aluminum foil.

      Symptoms
        Double vision and drooping eyelids
        Slurred speech
        Dry mouth and difficulty swallowing
        Weak muscles
      Symptoms of foodborne botulism usually begin within 18 to 36 hours after you eat contaminated food, but can occur in as few as 6 hours or as much as 10 days afterward.

      Diagnosis

      A health care provider can use laboratory tests to identify C. botulinum toxin in your blood or stool if you are infected.

      Treatment

      If you are diagnosed early, your health care provider can treat foodborne botulism successfully with an antitoxin that blocks the action of the bacterial toxin circulating in your blood. Although antitoxin keeps the disease from becoming worse, it will still take many weeks before you recover. Your health care provider may try to remove any contaminated food still in your gut by making you vomit or by giving you an enema.

      Prevention
        Follow strict hygienic steps when home canning.
        Refrigerate oils containing garlic or herbs.
        Keep baked potatoes wrapped in aluminum foil either hot until served or refrigerated.
        Consider boiling home-canned food before eating it to kill any bacteria lurking in the food.

      Complications

      If left untreated, this illness can cause paralysis of the arms, legs, trunk, and the muscles that help you breathe. The paralysis usually improves slowly over several weeks. People who develop severe botulism experience breathing failure and paralysis and need to be put on ventilators (breathing machines).

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    Foodborne E. coli

    Outbreaks of foodborne disease caused by E. coli (Escherichia coli) bacteria have become a serious problem in this country. E. coli O157:H7 (one type of the bacteria) has caused illness and major disease outbreaks in the United States. The Centers for Disease Control and Prevention (CDC) estimates 73,000 cases of infection with E. coli O157:H7 and 61 deaths occur in this country each year.
      Cause

      While there are many types of E. coli bacteria, only certain types cause foodborne illness. Hundreds of harmless strains of E. coli can be found widely in nature, including the intestinal tracts of humans and other warm-blooded animals. Disease-causing strains, however, are a frequent cause of both intestinal and urinary-genital tract infections.

      In 1982, scientists identified the first dangerous foodborne strain in the United States. The type of harmful foodborne E. coli most commonly found in this country is called O157:H7, which refers to chemical compounds found on the bacterium's surface. Cattle are the main sources of E. coli O157:H7, but these bacteria can be found in other domestic and wild mammals.

      Several different strains of harmful E. coli can cause diarrheal disease.

      • Particularly dangerous types E. coli, such as E. coli O157:H7, produce one or more Shiga toxins that can severely damage the lining of your intestines and kidneys. These types of strains are called Shiga toxin-producing E. coli (STEC). STEC often causes bloody diarrhea and can lead to kidney failure in children or people with weakened immune systems.
      • Enterotoxigenic E. coli (ETEC), which produce a different toxin, can cause diarrhea. These strains typically cause so-called travelers' diarrhea because they commonly contaminate food and water in developing countries.
      • Enteropathogenic E. coli (EPEC) cause persistent diarrhea (lasting 2 weeks or more) and are more common in developing countries where they can be transmitted to humans through contaminated water or contact with infected animals.
      Other types of E. coli, including O26:H11 and O111:H8, also have been found in the United States and can cause disease in people.

      Transmission

      E. coli O157:H7 and its toxins have been found in certain foods and liquids.
        Undercooked or raw hamburgers
        Salami
        Alfalfa sprouts
        Lettuce
        Unpasteurized milk, apple juice, and apple cider
        Contaminated well water
      Other ways you can get infected with E. coli include
        Swallowing unchlorinated or underchlorinated water in swimming pools contaminated by human feces
        Swimming in sewage-contaminated water
        Having direct contact with an infected family member
        Having direct contact with infected child in a child care center
      Symptoms

      E. coli O157:H7 toxin can damage the lining of your intestines and cause other symptoms including You might develop low-grade fever or vomiting. Symptoms usually begin from 2 to 5 days after you eat contaminated food or drink contaminated liquids and may last for 8 days. You should recover completely from the disease.

      Diagnosis

      Your health care provider can use lab tests to identify E. coli O157:H7 or Shiga toxin in your stool if you are infected. CDC recommends that any one who suddenly has diarrhea with blood get their stool tested for E. coli O157:H7.

      Treatment

      If you are like most people infected with E. coli O157:H7, you will get better within 5 to 10 days without treatment. Antibiotics are usually not helpful, and health care experts don't recommend taking antidiarrheal medicines.

      Prevention

        Wash your hands thoroughly after going to the bathroom or changing diapers.
        Eat only thoroughly cooked ground beef.
        Cook ground beef products to an internal temperature of 160 degrees Fahrenheit.
        Avoid unpasteurized milk and juices.
        Wash fresh fruits and vegetables thoroughly before eating raw or cooked.
        Keep raw meat separate from ready-to-eat foods.


      Complications

      Hemolytic uremic syndrome (HUS), a serious complication of STEC, can lead to kidney failure. In North America, HUS is the most common cause of acute kidney failure in children, who are particularly prone to this complication. This life-threatening condition is usually treated in an intensive care unit of a hospital, sometimes with blood transfusions and kidney dialysis.

      About 8 percent of people with HUS have other lifelong complications, such as high blood pressure, seizures, blindness, paralysis, and the effects of having part of their intestines removed.

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    Foodborne Norovirus Infection

    Noroviruses, including Norwalk, Snow Mountain, and Hawaii viruses, cause an illness in humans called gastroenteritis. Gastroenteritis is an inflammation of the stomach and intestines. Sometimes misnamed "stomach flu," gastroenteritis is not related to flu (influenza), a respiratory illness caused by influenza virus.

    Noroviruses are very contagious. They usually are found in contaminated food or drinks, but they also can live on surfaces or be spread through contact with an infected person. Each year in the United States, 23 million norovirus infections result in an estimated 50 thousand hospitalizations and 310 deaths.
      Cause

      The main viruses that cause gastroenteritis used to be called "Norwalk-like viruses" because Norwalk is the most well-known virus in this group. Now the viruses are referred to as noroviruses.

      Noroviruses are not new, but interest in them is growing as researchers learn how frequently they make people sick. Norovirus infections are implicated in newsworthy descriptions of outbreaks on military and cruise ships, in restaurants, daycare centers, nursing homes, and hospitals. Decontamination of these places has proved to be challenging.

      Noroviruses are not related to bacteria or parasites that also can cause gastrointestinal illnesses.

      Transmission

      You can get norovirus infection by

        Eating food or drinking liquids contaminated by a food handler infected with the virus
        Touching surfaces or objects contaminated with a norovirus, and then putting your hands in your mouth
        Having direct contact with someone infected with a norovirus, such as caring for or sharing food or eating utensils with someone sick with norovirus
        Eating improperly cooked contaminated shellfish, especially oysters
        Eating improperly prepared uncooked fruits and vegetables
        Drinking contaminated water
      Noroviruses are found in the stool or vomit of people who are infected. If you have been infected with a norovirus, you can continue to transmit it to others even when you no longer have symptoms.

      Symptoms

      Because there are so many types of noroviruses, you can become infected and show symptoms many times. Symptoms of gastroenteritis caused by noroviruses can include Symptoms usually develop within hours or a few days after you are infected with a norovirus. It usually takes a couple of days before you are better.

      Diagnosis

      Your health care provider can use laboratory tests to diagnose norovirus infection, but these tests are not used routinely. Usually, your health care provider will diagnose it by examining you and noting your symptoms.

      Treatment

      The best treatments for norovirus infection are to get plenty of bed rest and drink lots of fluids. To prevent dehydration (severe loss of body fluids), your health care provider may give you specific instructions about the type of fluids you should drink.

      You should not take antibiotics for norovirus infection because they have no effect on viruses.

      If your infant or child has diarrhea, you should contact a health care provider immediately for treatment advice.

      Prevention

      To prevent norovirus
      • Wash your hands with soap and water frequently. This is especially important for food handlers and caregivers.
      • Do not prepare food for others if you have norovirus infection.
      • Prepare fresh and frozen foods safely, including thoroughly washing fresh produce.
      • Disinfect contaminated surfaces in your kitchen and bathrooms with household chlorine bleach-based cleaners to kill viruses resting on surfaces.
      • Wash contaminated clothing, diapers, sheets, and towels promptly in hot water (above 140 degrees Fahrenheit) and/or with bleach.
      • Choose wisely when eating or drinking outside your home. If you aren't sure whether the food or water is safe, avoid it.

      Currently, there is no vaccine to protect you from norovirus infections.

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    Salmonellosis

    Salmonellosis, or salmonella, is one of the most common foodborne diseases. Overall, salmonella infections are decreasing in the United States but some types are still increasing.

    Salmonella may occur in small, contained outbreaks in the general population or in large outbreaks in hospitals, restaurants, or institutions for children or the elderly. While the disease is found worldwide, health experts most often report cases in North America and Europe. Every year, the Centers for Disease Control and Prevention (CDC) receives reports of 40,000 cases of salmonellosis in the United States. The agency estimates that 1.4 million people in this country are infected, however, and that 1,000 people die each year with salmonellosis. People with AIDS are particularly vulnerable to salmonellosis-often suffering from recurring episodes.
      Cause

      Many types of Salmonella bacteria cause salmonellosis in animals and people. While the occurrence of different types of Salmonella varies from country to country, S. typhimurium and S. enteritidis are the two most commonly found in the United States.

      An antibiotic-resistant strain of S. typhimurium, called Definitive Type 104 (DT104), was first found in the United Kingdom and then in the United States. It is the second most common strain (after S. enteritidis) of Salmonella found in humans. This strain poses a major threat because it is resistant to several antibiotics normally used to treat people with salmonella disease.

      Transmission

      Salmonella bacteria can be found in food products such as raw poultry, eggs, and beef, and sometimes on unwashed fruit. Food prepared on surfaces that previously were in contact with raw meat or meat products can, in turn, become contaminated with the bacteria. This is called cross-contamination.

      In recent years, CDC has received reports of several cases of salmonella from eating raw alfalfa sprouts grown in contaminated soil. You also can get salmonella after handling pets, particularly reptiles like snakes, turtles, and lizards.

      Salmonella can become a chronic infection even if you do not have symptoms. In addition, though you may have no symptoms, you can spread the disease by not washing your hands before preparing food for others. In fact, if you know you have salmonella, health care experts recommend you do not prepare food or pour water for others until laboratory tests show you no longer carry Salmonella bacteria.

      Symptoms

      The following symptoms usually begin from 12 hours to 3 days after you are infected.

      These symptoms, along with possible nausea, loss of appetite, and vomiting, usually last for 4 to 7 days.

      Symptoms are most severe in the elderly, infants, and people with chronic conditions such as diabetes or HIV infection.

      Diagnosis

      Your health care provider can use laboratory tests to identify Salmonella in your stool if you are infected.

      Treatment

      If you are like most people with salmonella, the disease will clear up within 5 to 7 days and you won't need to be treated. If you have severe diarrhea, however, you may need intravenous fluids. If the disease spreads from your intestines into your bloodstream, your health care provider can treat it with antibiotics such as ampicillin.

      Prevention
      • Don't drink milk that is unpasteurized.
      • Don't eat foods containing raw eggs, such as homemade caesar salad dressing, cookie dough, and hollandaise sauce, or drink homemade eggnog made with raw eggs.
      • Handle raw eggs carefully.
      • Cook eggs thoroughly.
      • Cook poultry products to an internal temperature of 170 degrees Fahrenheit for breast meat and 180 degrees Fahrenheit for thigh meat.
      • Wash thoroughly with soap and hot water all food preparation surfaces and utensils that have come in contact with raw poultry or raw eggs.
      • Wash hands immediately after handling raw poultry or raw eggs.
      • Wash hands immediately after handling reptiles or having contact with pet feces.

      Complications
        Reiter's Syndrome

        hile most people recover successfully from salmonella, a few may develop a chronic condition called Reiter's syndrome. This syndrome can last for months or years and can lead to arthritis. Its symptoms are painful joints, irritated eyes, and painful urination.

        Unless treated properly, Salmonella bacteria can escape from the intestine and spread by blood to other organs, sometimes leading to death.

        Typhoid Fever

        S. typhi bacteria can cause typhoid fever, a more serious disease. This disease, which can be fatal if untreated, is not common in the United States. Typhoid fever frequently occurs in developing countries, with the infection coming from contaminated water. It's also a risk in areas where flooding or earthquakes cause sewer systems to overflow. Appropriate antibiotics usually are effective for treating typhoid fever, although the number of cases of antibiotic-resistant S. typhi are increasing in some parts of the world.
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    Shigellosis

    Shigellosis is an infectious disease, which can be spread through contaminated food and water, and is a form of dysentery (an intestinal disease). The Centers for Disease Control and Prevention (CDC) estimates more than 400,000 cases occur every year in the United States. Health care providers report about 18,000 cases to CDC each year.

      Cause

      Shigellosis is caused by Shigella bacteria. Four main types of Shigella cause infection: S. dysenteriae, S. flexneri, S. boydii, and S. sonnei.

      Transmission

      You can be infected from Shigella by

        Eating food or drinking beverages contaminated by food handlers infected with Shigella who didn’t wash their hands properly after using the bathroom
        Eating vegetables grown in fields containing sewage
        Eating food contaminated by flies bred in infected feces
        Swimming in or drinking contaminated water
      S. sonnei is the most common type of Shigella in developed countries, including the United States. Outbreaks of shigellosis frequently occur in tropical or temperate climates, especially in areas with severe crowding and/or poor hygiene that sometimes occur in daycare and institutional settings.

      Even if you have no symptoms of shigellosis, you can still pass the bacteria to others. An extremely low number of bacteria (10 to 100) is needed to transmit the infection. Therefore, it is commonly transmitted by food handlers who are sick or infected, but have no symptoms, and who do not properly wash their hands after using the toilet. If you know you have shigellosis, you should not prepare food or beverages for others until laboratory tests show you no longer carry Shigella bacteria.

      Symptoms Symptoms usually begin within 2 days after you come in contact with Shigella. Symptoms usually are gone within 5 to 7 days.

      Diagnosis

      Laboratory tests can identify Shigella in your stool if you are infected. Sometimes, these tests are not performed unless the laboratory is instructed specifically to look for these bacteria. The laboratory can also do special tests to tell which type of Shigella you have and which antibiotics, if any, would be best to treat it.

      Treatment

      If you have a mild infection, you should get better quickly without taking medicine. If you need to be treated, your health care provider usually will prescribe an antibiotic such as ampicillin or ciprofloxacin. Antidiarrheal medicines may make the illness worse.

      Prevention
        Wash hands with soap and water before preparing foods and beverages.
        Wash hands after using the bathroom or changing infant diapers.
        Disinfect diaper-changing areas after use.
        Help young children wash their hands carefully after they use the bathroom.
        Avoid swallowing swimming pool water.


      Complications

      People who have diarrhea symptoms usually recover completely, although their bowel habits may not return to normal until several months later.

      S. dysenteriae type 1 bacteria produce Shiga toxin and can lead to life-threatening hemolytic uremic syndrome (HUS), which can lead to kidney failure. In North America, HUS is the most common cause of acute kidney failure in children, who are particularly prone to this complication. This life-threatening condition is usually treated in an intensive care unit of a hospital, sometimes with blood transfusions and kidney dialysis. About 8 percent of people with HUS have other lifelong complications, such as high blood pressure, seizures, blindness, paralysis, and the effects from having part of their intestines removed due to the disease.

      S. flexneri infection can progress to Reiter’s syndrome, which can last for months or years and can lead to chronic arthritis. Its symptoms are painful joints, irritated eyes, and painful urination.

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    Information obtained from National Institute of Health
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