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foodborne_disease-2_1.pptFood Infection
Part Deux
Big 5
- The Centers for Disease Control and Prevention and the FDA Food Code lists five of the pathogens that have high infectivity and are easily transmitted to food by sick employees.
- Norovirus
- Hepatitis A virus
- Salmonella Typhi
- Shigella
- Escherichia coli (E. coli) O157:H7 or other Enterohemorrhagic or Shiga toxin-producing E. coli.
Salmonella enteritidis
- associated with whole, uncracked eggs.
- Bacteria transmitted from infected hens into the egg.
- Caesar salads, egg nog
- snow cream prepared with raw eggs
- raw cookie dough
Raw eggs may be unrecognized in some foods such as homemade hollandaise sauce, Caesar and other homemade salad dressings, homemade ice cream, homemade mayonnaise, cookie dough, and frostings.
In Da News… E. coli in Nestle cookie dough stumps FDA (June 2009)
The outbreak appears to be linked to consuming uncooked Nestlé refrigerated and frozen Toll House cookie dough products.
- It has sickened 70 people nationwide
- 30 of whom have been hospitalized.
- No one has died.
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according to the Centers for Disease Control and Prevention
Nestlé says
…. the instructions "clearly state that the raw dough must be baked before consumption."
A bacterium, Salmonella enteritidis, can be inside perfectly normal-appearing eggs, and if the eggs are eaten raw or undercooked, the bacterium can cause illness.
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Egg-associated salmonellosis is an important public health problem in the United States and several European countries. A bacterium, Salmonella enteritidis, can be inside perfectly normal-appearing eggs, and if the eggs are eaten raw or undercooked, the bacterium can cause illness. During the 1980s, illness related to contaminated eggs occurred most frequently in the northeastern United States, but now illness caused by S. enteritidis is increasing in other parts of the country as well. Consumers should be aware of the disease and learn how to minimize the chances of becoming ill.
A person infected with the Salmonella enteritidis bacterium usually has fever, abdominal cramps, and diarrhea beginning 12 to 72 hours after consuming a contaminated food or beverage.
In the elderly, infants, and those with impaired immune systems the infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics.
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How eggs become contaminated
Salmonella enteritidis silently infects the ovaries of healthy appearing hens and contaminates the eggs before the shells are formed.
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Unlike eggborne salmonellosis of past decades, the current epidemic is due to intact and disinfected grade A eggs.
Most types of Salmonella live in the intestinal tracts of animals and birds and are transmitted to humans by contaminated foods of animal origin.
Stringent procedures for cleaning and inspecting eggs were implemented in the 1970s and have made salmonellosis caused by external fecal contamination of egg shells extremely rare.
The Egg Products Inspection Act
- The term "egg products" refers to eggs that have been removed from their shells for processing at facilities called "breaker plants.“
- The safety of these products is the responsibility of FSIS.
- Basic egg products include whole eggs, whites, yolks, and various blends—with or without non-egg ingredients—that are processed and pasteurized.
- They may be available in liquid, frozen, and dried forms.
Most are not available in supermarkets, but are used in restaurants, hospitals, and other foodservice establishments as well as by bakers, noodle makers, and other food manufacturers.
An infected hen can lay many normal eggs while only occasionally laying an egg contaminated with the Salmonella bacterium.
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The entire time from ovulation to laying is about 25 hours. Then about 30 minutes later, the hen will begin to make another one.
How does Salmonella infect eggs
- Bacteria can be on the outside of a shell egg.
- That's because the egg exits the hen's body through the same passageway as feces is excreted.
- That's why eggs are required to be washed at the processing plant.
- All USDA graded eggs and most large volume processors follow the washing step with a sanitizing rinse at the processing plant.
- It is also possible for eggs to become infected by Salmonella Enteritidis fecal contamination through the pores of the shells after they're laid.
- SE also can be inside an uncracked, whole egg.
Contamination of eggs may be due to bacteria within the hen's reproductive tract before the shell forms around the yolk and white. SE doesn't make the hen sick.
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- In these persons, a relatively small number of Salmonella bacteria can cause severe illness.
- Most of the deaths caused by Salmonella enteritidis have occurred among the elderly in nursing homes.
Egg-containing dishes prepared for any of these high-risk persons in hospitals, in nursing homes, in restaurants, or at home should be thoroughly cooked and served promptly.
Many dishes made in restaurants or commercial or institutional kitchens, however, are made from pooled eggs.
If 500 eggs are pooled, one batch in 20 will be contaminated and everyone who eats eggs from that batch is at risk.
To Reduce Risk..
Shell eggs are safest when stored in the refrigerator, individually and thoroughly cooked, and promptly consumed.
Cooking reduces the number of bacteria present in an egg; however, an egg with a runny yolk still poses a greater risk than a completely cooked egg.
- Undercooked egg whites and yolks have been associated with outbreaks of Salmonella enteritidis infections.
- Both should be consumed promptly and not be held in the temperature range of 41°F to 135°F for more than 2 hours.
Easter Eggs
Commercially manufactured ice cream and eggnog are made with pasteurized eggs and have not been linked with Salmonella enteritidis infections.
What else is being done?
- Government agencies and the egg industry have taken steps to reduce Salmonella enteritidis outbreaks.
- Identifying and removing infected flocks from the egg supply and increasing quality assurance and sanitation measures.
- Some states now require refrigeration of eggs from the producer to the consumer.
- The U.S. Department of Agriculture is testing the breeder flocks that produce egg-laying chickens to ensure that they are free of Salmonella enteritidis.
- Eggs from known infected commercial flocks will be pasteurized instead of being sold as grade A shell eggs.
- The U.S. Food and Drug Administration has issued guidelines for handling eggs in retail food establishments and will be monitoring infection in laying hens.
Working on eliminating Salmonella in eggs
- Federal and state governments
- Egg industry,
- Scientific community are working together to solve the problem.
- USDA's Food Safety and Inspection Service (FSIS)
- Agricultural Research Service (ARS)
- Animal and Plant Health Inspection Service (APHIS)
State departments of agriculture.
Treatment
- Severe dehydration
- Intravenous fluids
- Antibiotics
- Salmonella bacteria have become resistant
- Result of the use of antibiotics to promote the growth of feed animals.
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then it can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin.
People who have salmonellosis should not prepare food or pour water for others until they have been shown to no longer be carrying the Salmonella bacterium.
If many cases occur at the same time, it may mean that a restaurant, food or water supply has a problem.
If you are served undercooked meat, poultry or eggs in a restaurant, don't hesitate to send it back to the kitchen for further cooking.
Be particularly careful with foods prepared for infants, the elderly, and the immunocompromised.
Shigella
- Foodborne infection
- Found in intestines and feces of humans and warm-blooded animals
- Shigellosis
- Watery diarrhea
Symptoms and Onset Time
- Diarrhea, fever, abdominal cramps, chills, fatigue, dehydration
- Onset time:1-7 days
Common Foods
- RTE salads (potato, chicken)
- Milk, diary products
- Raw vegetables
Transmission
- Water contaminated by fecal matter
- Food and utensils handled by employees (carriers)
Prevention
- Restrict employees diagnosed with shigellosis to handle food.
- Handwashing
- Cook foods properly
- Prevent cross-contamination
- Wash produce with potable water
Shigellosis is particularly common and causes recurrent problems in settings where hygiene is poor and can sometimes sweep through entire communities.
- Shigellosis is more common in summer than winter.
- Toddlers aged 2 to 4, are the most likely to get shigellosis.
- A severe infection with high fever may also be associated with seizures in children less than 2 years old.
- Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.
- Everyone who changes the child's diapers should be sure the diapers are disposed of properly
- Wash hands carefully with soap and warm water immediately after changing the diapers.
After use, the diaper changing area should be wiped down with a disinfectant such as household bleach, Lysol* or bactericidal wipes.
Vibrio vulnificus
- Consuming raw oyster and shellfish harvested from polluted waters.
- People with compromised immune system are at great risk.
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Liver disease, alcoholism, viral hepatitis
Vibrio
- Foodborne infection
- Vibrio cholera, Vibrio parahaemolyticus, Vibrio vulnificus
- Found in saltwater
- Common in seafood
- Vibrio vulnificus bacteria are natural in saltwater species and can kill at risk population
- Clams, oysters, crabs, shrimps, lobster
- During summer months
- Fecal contamination
Symptoms and Onset Time
- Diarrhea, abdominal cramps, nausea, vomiting, headache, fever, chills
- Onset time: 2-48 hours
- Last 2-3 days or longer
Transmission in Food
- Cross-contamination
- Consumption of raw or undercooked seafood
- V. vulnificus causes disease in individuals who eat contaminated seafood (usually raw or undercooked oysters)
- Open wound that is exposed to seawater.
Prevention
- Purchase seafood from approved sources
- Cook to proper temps
- Avoid raw seafood (high risk groups)
- Good hygiene
- handwashing
Foodborne Illness Caused by Chemicals
- Naturally occurring (biological organisms)
- Man-made Chemicals (Processing)
Naturally Occurring Chemicals
- Ciguatoxin
- Mycotoxin
- Scombrotoxin
- Shellfish toxins
Ciguatoxins
- Intoxication caused by eating contaminated tropical reef fish.
- Toxin found in algae
- Toxic algae eating by small reef fish
- Eaten by bigger fish (mackerel, mahi, snapper)
- Toxins accumulate in flesh and skin
- Heat stable and not destroyed by cooking
Symptoms and Onset Time
- Nausea, vomiting, diarrhea, dizziness, shortness of breath
- Hot and cold sensation (classic symptom)
- Onset time: 30 minutes
- Death can occur
Common Foods
- Marine finfish
- Barracudas, grouper, jacks, mackerel, snapper
Transmission
Toxin is transferred to finfish when they eat toxin-containing algae or other fish that contain the toxin.
Prevention
- Toxin not destroyed by cooking
- Purchase seafood from reputable supplier
Scombrotoxin
- Also called histamine poisoning
- Caused by eating foods high in histamine.
- Histamine is usually produced by bacteria when they decompose food containing the protein .
- Histamine not inactivated by cooking.
Symptoms and Onset Time
- Dizziness, burning sensation, facial rash or hives, shortness of breath, peppery taste in the mouth when contaminated fish is eaten
- Recovery 8-12 hours
- Severe cases – loss of muscle control, inability to speak, swallow or breath can lead to death
Common Foods
- Tuna, anchovies, blue fish, mackerel, amberjack, abalone, and mahi-mahi
- Sardines
Transmission
- Leaving food out at room temperature can result in histamine production.
- Overtime bacteria can breakdown histidine and cause production of histamine.
Prevention
- Purchase seafood from a reputable supplier.
- Store fresh fish properly
- Do not accept fish that is suspected of being thawed and refrozen.
- Prevent temperature abuse
Scombroid Poisoning
Scrombroid or Histamine poisoning occurs when Scrombroid fish are time/temp abused
Tuna, mackeral, bluefish, skipjack, swordfish, bonito
Flushing, sweating, burning, peppery taste, dizzy, nausea, headache, rash, diarrhea, stomach cramps
Shellfish Toxins (Intoxication)
- Paralytic Shellfish Poisoning
- Diarrhetic Shellfish Poisoning
- Domoic Acid Poisoning
- Neurotoxic Shellfish Poisoning
Soft-shell clams exposed to 'red tide' events can develop a mutation that allows them to accumulate more Paralytic Shellfish Toxins (PSTs), making them more dangerous to humans.
Paralytic Shellfish Poisoning
Eating shellfish such as oysters, clams or scallops. contaminated with saxitoxin (nerve poison) caused by algae.
- Toxins are produced by certain algae called dinoflagellates.
- Filter-feeding shellfish such as mussels, clams, oysters, and scallops feed on toxic algae.
- Toxins accumulate in internal organs and become toxic to humans
Symptoms and Onset Time
- Numbness in the lips, tongue and tips of fingers…then
- Numbness in arms, legs and neck
- Lack of muscle coordination
- Respiratory distress
- Onset time: 30-60 minutes
(Domoic Acid- 10 minutes)
Transmission in Foods
- Contaminate shellfish by sports fisherman
- Harvested from polluted waters
- Commercially harvested shellfish are rarely involved in foodborne disease.
- Health agencies monitor levels of toxins.
- Harvesting prohibited when toxins exceed safe limits.
Prevention
Purchase from approved suppliers
Mycotoxins
- Poisonous substance produced by a fungus.
- Mycotoxins may affect foods such as peanuts.
Mycotoxin
- Fungi- molds, yeast, mushrooms
- Intoxication
- Fungi are larger than bacteria
- Prefer high sugar or starches
- Mycotoxins are chemical compounds produced by fungi while growing on organic substances such as corn, peanuts, or cottonseed.
- Usually growing on or in food.
- Consumption of mycotoxin-affected matter is a major cause of sickness and decreased performance in animals.
Fungi - Molds and Yeast
- Microscopic to giant mushrooms.
- Found naturally in air, soil, plants, animals, water, food
Molds
- Molds are fungi composed of tubular elements called hyphae.
- Hyphae are made of cells joined together end to end.
- Hyphae forms spores.
- Some molds, in the right conditions, produce mycotoxins—poisonous substances that can make you sick.
- Other molds are not only harmless, but also edible. Used to make certain cheeses.
- Mold can appear like a white coating, or like fuzzy green dots, on food surfaces.
Grows on fruit, vegetables, refrigerated meats, cheese, spices, nuts, popcorn.
- Molds are organisms that may be found indoors and outdoors.
- They are part of the natural environment and play an important role in the environment by breaking down and digesting organic material, such as dead leaves.
- Spores are so small they easily float through the air and can be carried for great distances by even the gentlest breezes.
- The number of mold spores suspended in indoor and outdoor air fluctuates from season to season, day to day, and even hour to hour.
Moldy Facts
- How it grows: Mold requires only minimal moisture & air to grow.
- The surface is just the tip of the iceberg—when a food shows heavy growth/fuzz, it means that “root threads have invaded it deeply.
- While most molds prefer warmer temperatures, they can grow at refrigerator temps, too.
- Molds can survive in salt & sugar better than most other food invaders, so you may find mold in items ranging from jams to cured ham or bacon.
Control
- Most killed by heat.
- Toxins not destroyed by heat.
- Freezing prevents growth
- Molds and yeast withstand more acidic foods and lower Aw.
- Molds and yeast are spoilage organisms
- Cause food to deteriorate
- Some shown to cause cancer
- Aflatoxin – produced by Aspergillus molds
- Many mycotoxins are not destroyed by cooking
What is Aflatoxin?
Aflatoxin refers to a group of extremely poisonous mycotoxins produced by two common fungi, Aspergillus flavus and Aspergillus parasiticus.
These toxins, produced by the fungus Aspergillus flavus, are among the most widespread and toxic of the mycotoxins, causing cancer and/or severe liver ailments in many species of animals.
Aspergillus flavus produces the highly potent mycotoxin called aflatoxin which over the years has been reported as the cause of death in humans and animals.
In 2004 aflatoxin killed over 100 people in an East African country who consumed grains infested by Aspergillus flavus.
- Aflatoxins are common contaminants of corn, peanuts, and many other cereal and oil seeds.
- Wildlife at risk when consume waste grain, especially during times of restricted access to other feed or forage.
Aflatoxin concentrations in waste grain are relatively common, especially under warm, humid conditions.
Symptoms and Onset Time
- Hemorrhage, acute liver damage
- Fluid buildup in the body
- Possible death
Common Foods
- Dry or acidic foods that do not support bacterial growth.
- Corn and corn products
- Pecans, walnuts
Prevention
- Purchase from approved suppliers
- Keep grains and nuts dry
- Protect from humidity
The Inn
Reheat Leftovers Rapidly!!!
