The Microworld

1. The Microworld

2. Foodborne Diseases

3. Definitions • Foodborne illness – Illness carried or transmitted to people by food. • Foodborne Infections – result of a person eating food containing pathogens, which then grow in the intestines and cause illness. • ( typically symptoms of foodborne illness do not appear immediately)

4. Definitions • Foodborne intoxication • Result of a person eating food containing toxins (poisons) that cause an illness. The toxins my have been produced by pathogens found on the food or may be result of a chemical contamination, or part of the natural food. • Appear quickly, within a few hours.

5. Definitions • Foodborne Toxin-mediated (Toxicoinfection) infection • Result of a person eating food containing pathogens which then produce illness-causing • toxins in the intestines. • Gastrointestinal illness • Illness relating to the stomach or intestine

6. Campylobacter jejuni • Foodborne Infection • Microaerophilic • Curved Rod shape • #1 cause of bacterial foodborne illness in U.S. • Est. 2-4 million cases a year • Guillian Barré Syndrome • Neuromuscular disease

7. Campylobacter jejuni • Common Foods • Poultry • Contaminated Water • Prevention Measures • Cook Food particularly poultry, to required minimum internal temperatures • Prevent Cross-contamination between raw and ready-to-eat food.

8. Salmonella spp. • Illness: Salmonlellosis • 2,300 serovars • Rod shaped, Non-spore forming • Facultative Anaerobe • Asymptomatic carrier • Carry pathogenic organism without symptoms • “typhoid mary” – Mary Malone • 53 people, 7 outbreaks, 3 deaths

9. Classification based on Disease Syndrome • Typhoid fever • Paratyphoid fever • Salmonellosis (Gastroenteritis)

10. Salmonella typhi • Habitat: GI tract of humans, polluted H2O • Vaccine • Poor Sanitation • Not common in U.S. • Infectious dose – 1-10 cells • Typhoid fever (Typhoid fever – once you have it cant get it again) • high fever – 105° F • Severe Diarrhea • Vomiting • Dehydration • Cartiovascular collapse • Death

11. Salmonella paratyphi • Habitat: GI tract of humans, Polluted H2O • Similar to typhoid fever but not as severe • Disease : paratyphiod fever

12. Salmonellosis/Gastroenteritis • Foodborne Infection • Severity depends on health, age, # cells • Onset: 6 – 72 hrs • Duration: 2-3 days • Symptoms • Nausea, Vomiting, Diarrhea • Headache, Fever, Chills • Sweating, Weakness

13. Salmonellosis/Gastroenteritis • Carriers/Implicated foods • Poultry – meat and eggs • Cattle – beef and dairy prod. • Swine – pork • RTE foods • Other implicated foods • Wildgame • Orange juice • Alfalfa sprouts • Nuts – Snickers • Cantaloupes/Melons

14. Control of Salmonella • Personal hygiene – Hand washing • Cooking/Pasteurization • Poultry 165°F for 15 sec. • Eggs • Raw or undercooked or minimally cooked eggs – pasteurized egg product • Keep adequately refrigerated will prevent any Salmonella present in the eggs from growing to higher numbers • Avoid Cross Contamination

15. Shigella spp. • Rod Shaped • Habitat – GI tract of humans • Small infective dose – 10 cells • Easily transmissible because of low infectious dose • Foodborne infection • Disease: Shigellosis or Bacilliary dysentary

16. Shigellosis • Disease of Armys, Asylums, and Prisons • Concentrated people • Dorms, school systems, military • Symptoms • Nausea, Vomiting • Abdominal Pain • Diarrhea (watery/bloody) • Fever/Chills • Prostration, Fatigue • Sever cases - HUS

17. Shigellosis • Onset: 1-3 days • Duration: 4 days or more • Most often , BUT Not always self limiting • Sometimes must use antibiotics • Transmited via fecal-oral route • Food Infection

18. Shigellosis • Implicated Foods • Heavily Handled Foods • Salads/Lettuce • Ready to Eat Meat products • Control • Personal Hygeine – Hand Washing • Exclude infected foodhandlers • Control flies inside and outside the establishment

19. Listeria monocytogenes • Rod • Non-spore forming • Psychrophile • Anaerobic • Habitat: • Decaying vegetative mater • Soil • GI tract of animals and humans • Cool, wet, damp processing environments

20. Listeria monocytogenes • Disease: Listeriosis • Onset: 3 to 70 days • Occurs most frequently in at risk populations • Opportunistic Pathogen • Prevention: • Watch sell-by date • Prevent cross-contamination • Cook meat to proper temperature

21. Symptoms Flu-like symptoms in healthy adults Fever Nausea Vommiting Diarrhea Chills At Risk (in addition to reg. symptoms) Rash Backache Headache Septicemia Meningitis Encephalitis Abortions Listeria monocytogenes

22. Listeria monocytogenes • Implicated Foods • Soft mexican style cheese • 1st documented outbreak in 1982 • 160 people ill • Luncheon Meat • Frankfurtures • Cooked products – eliminates competing bacteria • Cooked products – eliminates competing bacteria

23. Vibrio • Rods • Foodborne Infection • Non-spore Forming • Types: • V. parahaemolyticus • V. vulnificus • V. cholerae • V.alginolyticus • Illness: Vibrio parahaemolyticus Gastroenteritis • Japan – most common cause of FBI • Implicated Foods: • Raw or partially cooked oysters

24. Vibrio vulnificus • Diseases: • Vibrio vulnificus Primary Septicemia- Most common • At risk populations (liver disease) – 70 to 80% mortality • Fever/Chills • Nausea • Skin Lesions • Diarrhea and vomiting • Vibrio vulnificus Gastroenteritis – Less common • Diarrhea • Abdominal cramps

25. Vibrio • Vibrio cholerae • Disease: Cholera • Habitat: GI tract of humans • Symptoms • High fever, Severe watery diarrhea • Dehydration, Cardiovascular collapse, Death • Pandemic – worldwide outbreak • Vibrio alginolyticus • Habitat: Marine Environment • Causes Wound Infections • Soft tissue, Ear

26. Vibrio • Implicated Food: Raw or partially cooked shellfish (Bivalves- two shells) • Bioaccumulators – accumulate toxins • Prevention Measures • Purchase oysters from approved source • Cook oysters to required minimum internal temperatures • Light steaming improves safety but not fool proof.

27. Must post WARNING: • Eating raw Shellfish could be hazardous to heath • At-risk populations should not eat raw Shellfish • Shellfish Stock ID tags • Live, raw shellfish (shell still closed) • ID tags • When harvested • Where harvested • By whom harvested • Packer

28. Foodborne intoxication • Endotoxin – Toxin that is produced by a cell and is then expelled outside of the cell • Exotoxin – Toxin that is produced and remains inside the cell until the ruptures (cell death) and is then released • Types of toxins based on target organ • Enterotoxin – of the intestines; GI tract • Neurotoxin – Affects the CNS • Hepatotoxin – Affects the liver • Nephrotoxin – Affects the kidneys

29. Bacillus cereus • Spore Former – Produces an Endospore • Habitat: Soil • Facultative Aerobe • Cells – Rod shape

30. Symptoms Watery diarrhea Abdominal cramps/Pain Nausea, Vomiting Common Foods Cooked Corn Cooked Potatoes Cooked Vegetables Meat Products Cooked Rice dishes: Fried Rice Rice Pudding Starchy Foods Potatoes Pastas Bacillus cereus

31. Symptoms Nausea Vomiting Diarrhea, occasionally Abdominal cramps, occasionally Onset: 15 min – 6 hrs Duration: less than 24 hr Common Foods Cooked Rice dishes: Fried Rice Rice Pudding Starchy Foods Potatoes Pastas B. Cereus – emetic type

32. Prevention Measures • Cook food to required minimum internal temperature • Prevent Bacterial Growth and Toxin Production • Hold food at the proper temperature • Cool food Properly

33. Staphylococcus aureus • Cocci shape • Habitat: Hair, nose, throat, feathers and sores/boils/pimples • Disease: Staphylococcal Gastroenteritis • FB Intoxication – Exotoxin • Enterotoxin • Symptoms: • Nausea, Vomiting, Diarrhea • Abdominal pain, Headache • Sweating, with a decrease in body temp.

34. Staphylococcus aureus • Implicated Foods • High protein foods which are cooked • Meat, poultry, gravies, puddings, egg products • Salads containing PHF (egg, tuna, chicken, macaroni) • Common associations • Temperature abuse • Foods on hot holding lines not hot enough • Refrigeration not cold enough • Re-contamination from humans

35. Staphylococcus aureus • Prevention Measures • Personal Hygiene • Properly coved cuts on hands and arms • Restrict infected food handlers from working with or around food or food equipment • Minimize the time food spends in the Temperature Danger Zone • Cook, hold and cool food properly

36. Clostridium botulinum • Rod shaped • Obligate anaerobe • Spore Former • Habitat: Soil, Air, Water • Food Intoxication • Exotoxins • All neurotoxins • Heat stable to a point (Boil for 10 min)

37. Clostridium botulinum • Disease: Botulism • Botulism toxin mechanism • Blocks the release of a neurotransmitter • Acetylcholine • Causes Paralysis • Symptoms • Nausea, Vomiting, Abdominal pain • Diarrhea (constipation), Headache • Diplopia, Speech impairment, Incordination • Paralysis, Cardiac Failure • Respiratory Failure, Death

38. Clostridium botulinum Implicated Foods • Improperly canned foods (often home-canned) • FDA regulation – NO home-canned foods may be served • Modified Atmosphere Packaging • Controlled Atmosphere • Other Foods • Baked potatoes • Garlic-in-oil • Sautéed onions • Processed meats • Nitrates/Nitrites

39. Clostridium botulinum • Control • Avoid temperature abuse of Potentially Hazardous Food • Use only commercially prepared canned foods • Infant botulism – toxin mediated infection • “Floppy Baby Syndrome” • Underdeveloped gut flora • Honey/Syrup – not under 1 yr of age

40. Clostridium perfringens • Rod shaped • Obligate anaerobe – NO O2 • Spore Former • Habitat: Ubiquitous - Soil, Air, Water, GI tract • Toxin-mediated infection • Doesn’t compete well • Double every 8 minutes in right environment • 2-6% of humans are asymptomatic carriers

41. Clostridium perfringens • Disease: Clostridium perfringens Gastroenteritis • Symptoms: • Violent cramps • Explosive diarrhea – due to gas production • Headache • Nausea • NO vomiting

42. Escherichia coli • Both pathogenic and non-pathogenic serotypes • Habitat: GI tract of humans and animals • Rod shape • Non-spore forming • 5 types of Enterovirulent E. coli • Enterotoxigenic -- Enteroinvasive • Enteropathogenic Enterohemorrhagic • Enteroaggregative

43. Enterotoxigenic – ETEC • Toxin-mediated infection • Disease – Traveler’s Diarrhea • Symptoms: • Abdominal pain, Nausea, Vomiting, Watery Diarrhea, and Fever • Polluted Water • Enteropathogenic – EPEC • Severe form of infant diarrhea • 1940s & 1950s high mortality rate

44. Enteroaggregative - EAggEC • Infant diarrhea • Enteroinvasive – EIEC • Bacilliary Dysentary • Invades intestinal cells • Symptoms • Bloody diarrhea • Nausea • Vomiting • Fever • Chills

45. Enterohemorrhagic - EHEC • Shiga toxin-producing E. coli • *E. coli O157:H7 (Shiga like toxin I and II) • O26:H11 • O111:H8 • Habitat: GI tract of cattle and humans • Common Associated foods • Ground beef (raw and undercooked) • “Mature beef” – older/dairy cattle • Contaminated produce

46. EHEC • Diseases • Hemorragic Colitis - HC • More common • Affects colon • Hemolytic Uremic Syndrome - HUS • Affects Kidneys • Septcemia - “blood poisoning” • Infective dose - < 50 cells

47. Major Outbreak • Jack-In-the-Box • 600 ill • 3 deaths • Control • Ground Beef – Cook Internal Temp • FDA 155°F for 15 sec. • USDA 160°F for 15 sec • @ risk/medicare - 165°F for 15 sec • Nitrates • Pasturization of Juices • Hand Washing • Avoid Cross-contamination

48. Illnesses caused byViruses

49. Virus • Non-living • Must have a host to reproduce • Do not consume nutrients • Do not excrete waste products • Protein coat with DNA/RNA • Smallest microbial contaminant • Submicroscopic

50. Virus • Low Infective Doses • Fairly communicable through foods and direct contact • Many virus resistant to: • Sanitizers • Freezing • Heat • Resistance varies greatly