Food-borne illnesses

Each year in the United States, approximately 76 million food-borne illnesses occur, leading to 325,000 hospitalizations and over 5000 deaths.40 A number of bacterial and viral pathogens that have been discussed previously in this chapter (e.g., Salmonella, Shigella, Campylobacter, E. coli, and noroviruses) can cause food poisoning. Other bacteria that can cause foodborne illness include Staphylococcus aureus, C. perfringens, C. botu-linum, and Bacillus cereus (Table 73-5). Food poisoning should be suspected if at least two individuals present with similar symptoms after the ingestion of a common food in the prior 72 hours. 

In the United States alone, episodes of diarrheal illness result in 73 million physician consultations, 1.8 million hospitalizations and 3,100 deaths each year. Food-borne illnesses alone account for 76 million illnesses and 350,000 hospitalizations each year [15, 18, 19]. 

In an infected open wound scenario, the infection spreads in 1 to 3 days from an original contaminated wound site into the subcutaneous tissue and muscle. The result is a foul-smelling discharge progressing to necrosis and fever. Toxemia, shock, and death may follow. With a naturally-occurring food-borne illness, a... 

In recent years, strong evidence of an increase in the magnitude, duration, and geographical distribution of food-borne illnesses caused by seafood toxins has been presented. The effect can be seen in the form of impediments to the development, growth, and stability of the local and commercial seafood industries in various areas of the world—most noticeably throughout the tropics where an abundant, accessible seafood resource resides. 

According to Smith (88), food products are prone to accidental and deliberate abuse. Contamination can occur at any point from the raw material to finished product upon consumption. Public concern related to food borne illness is growing and rapid detection of these pathogens and contaminants is important for food safety. 

Salmonella and Listeria are a source of numerous food borne illness. As a result, a lot of attention has been focused on these microorganisms. The effort in the Salmonella area focused on obtaining antibodies which can detect several serotypes (14-16, 61,64, 90) and shortening the assay time from 3-4 days to 1-2 days by use of more sensitive formats and enrichment protocols (74, 75, 91,92). Numerous immunoassay kits for Salmonella were developed, such as the Salmonella-Tek (74, 75), Tecra Salmonella (93) and Bio-Enza Bead (94), to name a few. More information on kits is given in section 2.9. Additional information is available for Salmonella, Listeria and other microbiological contaminants and toxins (see Table 1) in review articles and books (5, 7,11-13, 88,95-99). 

E. sakazakii is an opportunistic pathogen that has been associated with food-borne illness in neonates. Only two major serotypes - Ol and 02 have been identified. The two O antigen gene clusters are located between the galF and gnd genes, and both have the Wzx/Wzy pathway (Mullane et al., 2008). 

Naimi, T.S., Wicklund, J.H., Olsen, S.J., Krause, G., Wells, J.G., Bartkus, J.M., Boxrud, D.J., Sullivan, M., Kassenborg, H., Besser, J.M., Mintz, E.D., Osterholm, M.T. and Hedberg, C.W. (2003) Concurrent outbreaks of Shigella sonnei and enterotoxigenic Escherichia coli infections associated with parsley implications for surveillance and control of food borne illness. Journal of Food Protection 66, 535-541. 

James, K.J., Fidalgo Saez, M.J., Furey, A., and Lehane, M. 2004. Azaspiracid poisoning, the food-borne illness associated with shellfish consumption. Food Additives and Contaminants 21, 879-892. 

BucKholz, U., Mermin, J., Rios, R., Casagrande, T.L., Galey, F., Lee, M., Quattrone, A., Farrar, J., Nagelkerke, N., Werner, S.B. (2002). An outbreak of food-borne illness associated with methomyl-contaminated salt. JAMA 288 604—10. 

Consumed oysters are more likely than other seafood items to contain infective microorganisms because they recover and contain pathogens from surrounding waters and are very often eaten raw (Rippey, 1994 Wallace et al., 1999). In the United States, 8% of approximately 33 million food-borne illnesses annually have been linked to the consumption of raw oysters (Altekruse et al., 1999). Clams, mussels, cockles, and scallops are less of a public health concern because they are usually consumed cooked or steamed, which significantly alters the infectivity of potential pathogens (Rippey, 1994). 

Mead, P.S., Slutsker, L., and Dietz, V. 1999. Food-borne illness and death in the United States. Emerg. Inf. Dis. 5, 607-625. 

Cabe-Sellers, B.J. and Beattie, S.E. 2004. Food safety Emerging trends in food-borne illness surveillance and prevention. Journal of the American Dietetic Association 104 1708-1717. 

Reduces risk of food-borne illness from baeteria. 

Food-borne illness can become a significant threat in a large, complex food processing and distribution system. In 1993, for example, more than 500 persons in the Pacific Northwest became ill from eating undercooked hamburger and four persons died. This outbreak of food-borne illness was attributed to a pathogenic strain of the common intestinal bacterium E. coli 0157 H7 which appears to be harmless to cattle, but which can cause serious disease in humans (3). 

R Martin. Food-borne illness cases underscore safety issues. Nation s Restaurant News 29(12) 1, 82, 1995. 

B McCarthy. Handle with care, train staff in safe food handling to prevent food borne illness. Restaurant Inst April 22 72-74, 82, 1992. 

Precautions A food-borne illness that can cause diarrhea, abdominal cramps, fever, and possibly bloody stools. Conditions can last for a week or more. 

Recently, several agencies collaborated on a new pnblication to help increase awareness of food-borne illnesses among physicians. The primer. Diagnosis and Management of Foodborne Illness A Primer for Physicians and Other Health Care Professionals, was prodnced by the AMA, the American Nurses Association (ANA), the CDC, the Center for Food Safety and Applied Nutrition... 

Prevention in Atlanta estimates that food-borne illness causes as many as 9000 deaths per year. Irradiation provides one way to reduce microbial contamination in food. It does not solve the problem of careless handling of food by processors, and long-term studies on humans have not yet been concluded regarding irradiated food supplies. Once again, we face the issue of balancing benefit and risk. 

The Food Industry. As the epidemiology of food-borne illness evolves, regulatory concern is increasingly directed at industries involved in food... 

The Centers for Disease Control and Prevention (GDC), founded in 1946, and part of the U.S. Department of Health and Human Services, is concerned with infectious and chronic diseases, injuries, and disabilities in and out of the workplace, as well as environmental health hazards. The GDG s Foodbome Diseases Active Surveillance Network (FoodNet) collaborates with industry, state health departments, and federal food regulatory agencies to monitor outbreaks of food-borne illness. 

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