United States foodbome outbreaks

In the United States, cholera was prevalent in the 1800s but has been virtually eliminated by modem sewage and water treatment systems. However, as a result of improved transportation, more persons from the United States travel to parts of Latin America. Africa, or Asia where epidemic cholera is (K curring. U.S. travelers to areas with epidemic cholera may be exposed to the cholera bacterium. In addition, travelers may bring contaminated seafood back to the United States foodbome outbreaks have been caused by contaminated seafood brought into this country by travelers. 

Centers for Disease Control and Prevention, Surveillance for foodbome disease outbreaks - United States, 1988-1992, MMWR Morb. Mortal. Wkly. Rep., 45, SS-5, 1, 1996. 

Anonymous 1996. Surveillance for foodbome-disease outbreaks—United States, 1988-1992. MMWR... 

The typical manifestation of botuhsm is a flaccid paralysis that is bilateral and descending, involving primarily skeletal muscle but also stractures innervated by autonomic parasympathetic fibers. Human intoxication is caused by serotypes A, B, E, and, to a much lesser extent, by serotype F and is manifested as foodbome, wound, and infant botulism. Wound and infant botulism, however, are usually confined to serotypes A and Data compiled for foodbome botulism during the past 50 years in the United States indicate that serotype A was responsible for 37.6% of all outbreaks while sertoypes B, E, and F accounted for 13.7%, 15.1%, and 0.7%, respectively, of intoxications in which serotype involvement was established. ... 

Although infant botulism was not recognized until a large outbreak occurred in California in 1976, it is currently the most prevalent form of botulism in the United States, accounting for approximately 70% of aU cases. Because infant botulism results from a continual elaboration of BoNT, it is more effectively treated by antitoxin than is foodbome botulism. Recently concluded clinical trials carried out with a human botulinum immune globulin (BIG) has revealed a greater than two-fold reduction in the mean duration of hospitalization in infants treated with BIG treatment was effective even when infusion was initiated several days after the onset of symptoms (Amon, personal communication). 

In the United States an average of 110 cases of botulism are reported each year. Of these, approximately 25% are foodbome. 72% arc infant botulism, and the rest are wound bomlism. Outbreaks of foodbome botulism involving two or more persons occur most years and usually caused by eating contaminated home-canned foods. The number of cases of foodbome and infant botulism has changed little in recent years, but wound botulism has increased because of the use of biack-tar heroin, especially in California. 

Foodbome illnesses caused by pathogenic bacteria such as Salmonella, Listeria, and Escherichia coli have become a major health concern in the United States. The Centers for Disease Control and Prevention estimates that each year, E. coli in contaminated foods infects 20 000 people in the United States and that 500 people die. E. coli has been responsible for outbreaks of illness from contaminated ground beef, fruit juices, lettuce, and alfalfa sprouts. 

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