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A foodborne illness, also foodborne disease and commonly called food poisoning, is any illness resulting from the consumption of food contaminated with infectious or toxic agents; it can affect any person.[1] Infectious agents include pathogenic bacteria, toxins, viruses, prions or parasites. Such contamination usually arises from improper handling, preparation, or food storage. Good hygiene practices before, during, and after food preparation can reduce the chances of contracting an illness. The action of monitoring food to ensure that it will not cause foodborne illness is known as food safety. Foodborne disease can also be caused by a large variety of toxins that affect the environment. For foodborne illness caused by chemicals, see Food contaminants.
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Transmission
Ill food handlers are one of the most common sources of foodborne illnesses. Some common diseases are occasionally transmitted to food through the water vector. These include infections caused by Shigella, Hepatitis A and the parasites Giardia lamblia and Cryptosporidium parvum. Contact between food and pests, especially flies, rodents and cockroaches, are other food contamination vectors.
Foodborne illness can also be caused by the presence of pesticides or medicines in food, or by unintentionally consuming naturally toxic substances like poisonous mushrooms or reef fish.
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Symptoms and mortality
Symptoms typically begin several hours to several days after ingestion and depending on the agent involved, can include one or more of the following: nausea, abdominal pain, vomiting, diarrhea, fever, headache or tiredness. In most cases the body is able to permanently recover after a short period of acute discomfort and illness. However, foodborne illness can result in permanent health problems or even death, especially in babies, pregnant women (and their fetuses), elderly people, sick people and others with weak immune systems. Similarly, people with liver disease are especially susceptible to infections from Vibrio vulnificus, which can be found in oysters.
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Incubation period
The delay between consumption of a contaminated food and appearance of the first symptoms of illness is called the incubation period. This ranges from hours to days (and rarely months or even years, such as in the case of Listeriosis or Creutzfeldt-Jacob disease), depending on the agent, and on how much was consumed. If symptoms occur within 1-6 hours after eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than live bacteria.
During the incubation period, microbes pass through the stomach into the intestine, attach to the cells lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a toxin that is absorbed into the bloodstream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe. [1]
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Infectious dose
The infectious dose is the amount of agent that must be consumed to give rise to symptoms of foodborne illness. The infective dose varies according to the agent and consumer's age and overall health. In the case of Salmonella, in healthy human volunteers, a relatively large inoculum of 10 million to 100 million organisms is necessary to produce symptoms[2], as Salmonellae are very acid sensitive. However, an artificially higher stomach pH level greatly reduces the number of bacteria required to cause symptoms (by 10- to a 100-fold).
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Pathogenic agents
See also: Pathogen
An early theory on the causes of food poisoning involved ptomaines, alkaloids found in decaying animal and vegetable matter. While some poisonous alkaloids are the cause of poisoning, the discovery of bacteria left the ptomaine theory obsolete.
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Bacteria
Bacteria are a common cause of foodborne illness. In the United Kingdom during 2000 the individual bacteria involved were as follows: Campylobacter jejuni 77.3%, Salmonella 20.9%, Escherichia coli O157:H7 1.4%, and all others less than 0.1% [3]. In the United States, noroviruses are the most common cause of foodborne illness, causing 57% of outbreaks in 2004. In the past, bacterial infections were thought to be more prevalent because few places had the capability to test for norovirus and no active surveillance was being done for this particular organism. Symptoms for bacterial infections are delayed because the bacteria need time to multiply. They are usually not seen until 12-72 hours or more after eating contaminated food.
Common bacterial foodborne pathogens are:
Bacillus cereus
Brucella spp.
Campylobacter jejuni which causes Guillain-Barré syndrome
Listeria monocytogenes
Corynebacterium ulcerans
Coxiella burnetii or Q fever
Escherichia coli O157:H7 enterohemorrhagic (EHEC) which causes hemolytic-uremic syndrome
Escherichia coli - enteroinvasive (EIEC)
Escherichia coli - enteropathogenic (EPEC)
Escherichia coli - enterotoxigenic (ETEC)
Escherichia coli - enteroaggregative (EAEC or EAgEC)
Salmonella
Listeria monocytogenes
Plesiomonas shigelloides
Salmonella spp.
Shigella spp.
Streptococcus
Vibrio cholerae, including O1 and non-O1
Vibrio parahaemolyticus
Vibrio vulnificus
Yersinia enterocolitica and Yersinia pseudotuberculosis
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Exotoxins
In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by exotoxins which are excreted by the cell as the bacterium grows. Exotoxins can produce illness even when the microbes that produced them have been killed. Symptoms typically appear after 1-6 hours depending on the amount of toxin ingested.
Clostridium botulinum
Clostridium perfringens
Staphylococcus aureus
Bacillus cereus
For example Staphylococcus aureus produces a toxin that causes intense vomiting. The rare but potentially deadly disease botulism occurs when the anaerobic bacterium Clostridium botulinum grows in improperly canned low-acid foods and produces a powerful paralytic toxin.
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Emerging foodborne pathogens
There is still a lot we do not know about foodborne illness. Sixty some percent of outbreaks are still caused by unknown sources.
Aeromonas hydrophila, Aeromonas caviae, Aeromonas sobria
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Preventing bacterial food poisoning
The prevention is mainly the role of the state, through the definition of strict rules of hygiene and a public service of veterinary survey of the food chain, from farming to the transformation industry and the delivery (shops and restaurants). This regulation includes:
traceability: in a final product, it must be possible to know the origin of the ingredients (originating farm, identification of the harvesting or of the animal) and where and when it was processed; the origin of the illness can thus be tracked and solved (and possibly penalized), and the final products can be removed from the sale if a problem is detected;
respect of hygiene procedures like HACCP and the "cold chain";
power of control and of law enforcement of the veterinarians.
At home, the prevention mainly consists of:
separating foods while preparing and storing to prevent cross contamination. (i.e. clean cutting boards, utensils, and hands after handling meat and before cutting vegetables, etc.)
washing hands and/or gloves before handling ready-to-eat foods.
respecting food storage methods (hot foods hot and cold foods cold) and food preservation methods (especially refrigeration), and checking the expiration date;
avoiding over-long storage of left-overs;
washing the hands before preparing the meal and before eating;
washing the fresh fruits and vegetables with clear water, especially when not cooked (e.g. fruits, salads), scrubbing firm fruits and vegetables with a brush to clean;
washing the dishes after use, rinsing them well in hot water and storing them clean and dry;
keeping work surfaces and chopping boards clean and dry;
keeping the kitchen and cooking utensils clean and dry;
not relying on disinfectants or disinfectant-impregnated cloths and surfaces as a substitute for good hygiene methodology (as above);
preventing pets walking on food-preparation surfaces.
Bacteria need warmth, moisture, food and time to grow. The presence, or absence, of oxygen, salt, sugar and acidity are also important factors for growth. In the right conditions, one bacterium can multiply using binary fission to become four million in eight hours. Since bacteria can be neither smelled nor seen, the best way to ensure that food is safe is to follow principles of good food hygiene. This includes not allowing raw or partially cooked food to touch dishes, utensils, hands or work surfaces previously used to handle even properly cooked or ready to eat food.
High salt, high sugar or high acid levels keep bacteria from growing, which is why salted meats, jam, and pickled vegetables are traditional preserved foods.
The most frequent causes of bacterial foodborne illnesses are cross-contamination and inadequate temperature control. Therefore control of these two matters is especially important.
Thoroughly cooking food until it is piping hot, i.e. above 70 °C (158 °F) will quickly kill most bacteria, parasites and viruses. Clostridium botulinum, Clostridium perfringens and Bacillus cereus, produce a heat-resistant spores that survive temperatures up to 100 °C (212 °F). Norovirus and Hepatitis A can sometimes survive temperatures up to 190°F. Once cooked, hot foods should be kept at temperatures out of the danger zone. Temperatures above 63 °C (135 °F) stop microbial growth.
Cold foods should also be kept colder than the danger zone, below 5 °C (41 °F). However, Listeria monocytogenes and Yersinia enterocolitica can both grow at refrigerator temperatures.
Hot foods should be held at 57°C (135 °F) or hotter until ready to cool. Hot foods need to be cooled quickly to limit the amount of time the food is in the danger zone (temperature range at which bacteria can grow.) The food should be cooled from 57 °C (135 °F) to 20 °C (70 °F) within two hours. Then further chilled to less than 5 °C (41 °F) in 4 hours. Foods take much longer to cool than most people realize. Food should then be held chilled at 5 °C (41 °F) or less.
In August 2006, the United States Food and Drug Administration approved Phage therapy which involves spraying meat with viruses that infect bacteria, and thus prevents infection with bacteria. This has raised concerns since without mandatory labelling consumers won't be aware that meat and poultry products have been treated with the spray. [4]
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Viruses
Viral infections make up perhaps one third of cases of food poisoning in developed countries (In the US more than 50% of cases are viral). They are usually of intermediate (1-3 days) incubation period, cause illnesses which are self-limited in otherwise healthy individuals, and are similar to the bacterial forms described above.
Rotavirus
Norovirus (formerly Norwalk virus)
Rotavirus
Hepatitis A is distinguished from other viral causes by its prolonged (2-6 week) incubation period and its ability to spread beyond the stomach and intestines, into the liver. It often induces jaundice, or yellowing of the skin, and rarely leads to chronic liver dysfunction.
Hepatitis E
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Parasites
Most foodborne parasites are zoonoses.
Platyhelminthes:
Diphyllobothrium sp.
The scolex of Tenia solium
Nanophyetus sp.
Taenia saginata
Taenia solium
Fasciola hepatica
See also: Tapeworm and Flatworm
Nematode:
Anisakis sp.
Ascaris lumbricoides
Eustrongylides sp.
Trichinella spiralis
Trichuris trichiura
Protozoa:
Giardia lamblia
Acanthamoeba and other free-living amoebae
Cryptosporidium parvum
Cyclospora cayetanensis
Entamoeba histolytica
Giardia lamblia
Sarcocystis hominis
Sarcocystis suihominis
Toxoplasma gondii
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Natural toxins
In contrast several foods can naturally contain toxins that are not produced by bacteria and occur naturally in foods, these include:
Aflatoxin
Alkaloid
Red kidney beans
Ciguatera poisoning
Grayanotoxin (honey intoxication)
Mushroom toxins
Phytohaemagglutinin (Red kidney bean poisoning)
Pyrrolizidine alkaloid
Shellfish toxin, including Paralytic shellfish poisoning, Diarrhetic shellfish poisoning, Neurotoxic shellfish poisoning, Amnesic shellfish poisoning and Ciguatera fish poisoning
Scombrotoxin
Tetrodotoxin (Fugu fish poisoning)
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Other pathogenic agents
Prions, resulting in Creutzfeldt-Jakob disease
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2006-10-24 16:32:17
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answered by Anonymous
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