Food Borne Disease Presentation Final

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    SUBMITTED BYDIPTI SUGANDH

    AND

    NARINDER KAUR

    (M.TECH FBT)

    03/09/2010Semester I

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    Food Borne Diseases

    FOOD INTOXICATION FOODINFECTION

    Chemical or natural toxinproduced by micro organism (also

    called as exotoxin)causes disease

    Incubation period is shorter

    Most prevelant symptoms: nausea

    and vomiting

    Staphylococcus aureus,

    Clostridium perfringens, and

    Clostridium botulinum

    Micro organism itself grow insidethe body and causes disease

    Incubation period is longer

    Most prevelant symptoms:

    diarrhea, stomach cramps, fever

    and chills

    Salmonella, Enteropathogenic

    E.coli, Listeria monocytogenes,

    Shigella, Vibrio parahaemolyticus,

    Norwalk Viruses, and Hepatitis A

    It is the illness caused due to ingestion of food contaminated with

    pathogens.

    There are two types of food borne diseases:

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    --Reference from Modern Microbiology by Jay 7thedition, Springer 2005

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    FOOD BORNE INFECTION Illness caused when the pathogenic organism is

    ingested and it grow in body thus causing damage.

    They are caused by viable, multiplyingmicroorganisms that invade the Gastrointestinal Tract.

    Submitted byDIPTI SUGANDH

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    ORGANISM CHARACTERISTIC SOURCE OFCONTAMINATION

    DISEASE

    Salmonella Present in fecal matter inhuman and animalsGram negative bacteriaFacultative anaerobe Optimum growth conditions:pH 4 and 37 degree Celsius.

    Drinking water andfood contaminated

    with feces. Also,

    Poultry, eggs,unpasteurized milk.

    Vegetables grown infields exposed tosewage, pollutedcontaminated

    irrigation water

    Enteric fever,gastroenteritis,septicemia

    Escherichiacoli

    Generally Present in Gut Florabut enteropathogenic strains

    enter through food Gram Negative rodsProduce endotoxinsOptimal temperature forgrowth- 37 degree celsiusand pH 4.5-8

    Travelers

    diarrhoea, acute

    gastroenteritis inchildren

    Shigella Gram negative rodFacultative anaerobeProduce enterotoxins (shigatoxin), a neurotoxinCannot penetrate the

    intestinal wallOptimum temperature for

    Shigellosis(bacillarydysentery)Diarrheacontaining blood,

    pus, mucus

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    SALMONELLA Genus: Enterobactericeae

    Species: Salmonella

    Have 2500 serotypes

    Grouped based on on antigenic patters of Somaticantigen (O), Flagellar antigen (H) and Capsular antigen (Vi).

    Two subspecies : S.enterica and S.bongori

    Infections caused by salmonella are

    Enteric Fever ( typhoid and paratyphoid fever) Gastroentritis

    Septicemia

    Can be destroyed by ionizing radiation, pasteurization andfreezing

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    Reference -Food Borne Microbial Pathogens by Arun.K.Bhunia, Foodscience text series, Springer 2008

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    Invasion of Salmonella in the Host

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    List of few serovars with their pathway of

    invasion

    SEROVAR NAME HUMAN DISEASE PATHWAY OFINVASION

    S.paratyphi Enteric (paratyphoid)fever or Gastroentritis

    M cells and dendriticcells

    S.Typhimurium Gastroentritis,septicemia, or focalinfection

    M cells, dendritic cells

    S.Cholerasius Enteric fever or

    Gastroentritis

    M cells , dendritic cells

    and membrane ruffling

    S.Typhi Enteric (typhoid) fever M cells and dendriticcells

    S.enteritidis Gastroentritis Membrane ruffling

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    ENTERIC FEVER GASTROENTRITIS SEPTICEMIA

    Incubation time 1 weekto 1 month

    Incubation time 12-24hrs

    Symptoms appear in 1-2

    weeks:High fever, anorexia,chills,convulsions,delerium

    Symptoms appear in 6-24 hrs:

    Fever, bloody or non bloodydiarrhoea, abdominal pain andsometimes vomitingSymptoms persist for 2-3 days

    Symptoms:

    High fever, chills, rapidbreathing and heartrate, red spots on body(petechiae) .

    Diagnosis:ELISA, Dot blot immunoassay ,Nucleic acid based assays such as RT-PCR can be used for detection.

    Widal test for is specifically used for detection of typhi and paratyphi.

    Treatment:

    Flouroquinolone is mosteffective.Prevention: Liveattenutated Oral Vaccineavailable

    Treatment : It is self limiting

    hence no antibiotics are given. Butto prevent systemic infectionchloramphenicol can be given.

    Treatment:

    Ampicillin orchloramphenicol

    Even after treatment canlead to secondary infection.

    Disease lasts for 2-5 days withoutmedication

    Recurrent infection canlead to damage of

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    Recent outbreak of Salmonella enteritidis From May 1- August 25, 2010 was reportedin eggs in the U.S by the Centre of Disease Control and Prevention.

    Ref : http://www.cdc.gov/salmonella/enteritidis/

    OUTBREAK

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    PrecautionsA few simple precautions can reduce the risk of food borne diseases:

    Hands should be washed before preparing food and people suffering from diarrheal illness shouldavoid food preparation as this can spread salmonella, shigella , Ecoli.

    CLEAN: Fresh fruits and vegetables should be rinsed in running tap water to remove visible dirt andgrime, Also the outermost leaves of a head of lettuce or cabbage should be discarded. This is becausebacteria can grow well on the cut surface of fruit or vegetable. Care should be taken to not

    contaminate these foods while slicing and the cut produce should be avoided to be left at roomtemperature for many hours.

    SEPARATE: Avoid cross-contaminating foods by washing hands, utensils, and cutting boards afterthey have been in contact with raw meat or poultry and before they touch another food. Cookedmeat should be put on a clean platter, rather back on one that held the raw meat.

    COOK :meat, poultry and eggs thoroughly. Using a thermometer to measure the internaltemperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For

    example, ground beef should be cooked to an internal temperature of 160o

    F. Eggs should be cookeduntil the yolk is firm.

    CHILL: Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are notgoing to be eaten within 4 hours. Large volumes of food will cool more quickly if they are dividedinto several shallow containers for refrigeration.

    REPORT: Suspected food borne illnesses should be reported immediately to the local healhdepartment. The local public health department is an important part of the food safety system.

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    References: Text book ofFood Borne diseases by Dean.O.Oliver,

    Academic Press, 1990

    Food science text series,Modern Food Microbiology byJames.N.Jay, 7th edition Springer 2005

    Food Science text series, Food Borne MicrobialPathogens by Arun.k.Bhuniya, Springer, 2008

    Tata McGraw Hill Publishing company Limited,Textbook of Microbiology by M.Pelczar, 5th edition,2005

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    FOOD BORNE INTOXICATION

    Refers to ingestion of toxins contained within the food

    including bacterially produced exotoxins, which can happen

    even when the microbe which produced the toxin is no longer

    present or is not able to cause the infection

    Bacterial intoxication: exotoxins produced by bacteria are

    responsible for causing illness

    Non bacterial intoxication: presence of harmful chemicals like

    fertilizers, pesticides etc. causes illness

    Submitted by:

    Narinder Kaur

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    CAUSES OF FOOD INTOXICATION Presence of bacterium in the water.

    The staples for the food might arrest toxins.

    Food coaches may have a few infective diseases.

    Some animals like dogs, rats might pollute the food.

    Advisedly human blending toxins in the food. e.g. In spices etc.

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    MECHANISM OF ACTION

    Intake of contaminated food

    Incubation period delay between intake of contaminated food and appearance of

    first symptom of illness

    Ranges from hours to days depending upon type and quantityof food intake

    Incubation period of 1-6 hrs shows infection by a bacterialtoxin or chemical rather than by live bacteria

    During the incubation period, microbes pass through thestomach into the intestine, attach to the cells lining the

    intestinal walls, and begin to multiply there. Some types ofmicrobes stay in the intestine, some produce a toxin that isabsorbed into the bloodstream, and some can directly invadethe deeper body tissues. The symptoms produced depend onthe type of microbe

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    MICRO ORGANISMS & THEIR SOURCE,SYMPTOMS & PREVENTION

    OF FOOD INTOXICATION

    Micro

    organism

    Char

    acteri

    stics

    source Food

    containing

    micro

    organism

    symptoms prevention

    Staphylococ

    cus aureus

    Heat

    stable

    Domestic

    animals;

    cuts,

    scratches,

    boils,

    pimples of

    the skin

    Prefer pH

    above 4.5, so

    found in acid

    juices like

    tomatoes,

    citrus juices,

    pickles etc,

    headache,

    nausea,

    vomiting,

    stomach

    cramps,

    diarrhea

    1. As it grows well

    in rang e 40-

    140F, so food

    should be cooled

    below or heated

    above this range

    2. Keep cuts, sorescovered and

    avoid hand

    contact with

    cooked food

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    Micro

    organism

    Characteris

    tics

    source Food

    containing

    microorganism

    symptoms prevention

    Clostridium

    botulinm

    Anaerobe,

    heat

    resistant

    spore,

    produces

    toxins b/w

    38F-118F

    Soil,

    water,

    sewage,

    intestine

    s of

    human

    and

    animals

    Grow

    above pH

    4.6, so

    meats and

    most

    vegetables

    contain it

    fatigue, dizziness,

    headache,

    vomiting,

    diarrhea, nausea,

    acute indigestion

    followed by

    constipation,

    vision, difficulty

    swallowing or

    speaking. Throat

    constriction and

    muscle paralysis

    come in

    the final stages,

    followed by death

    due tosuffocation,

    use an

    approved

    processing

    time and

    temperature

    when home

    canning

    food.

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    Staphylococcusaureus Introduction: Widespread and relatively frequent; one of the principal acutefood intoxications in North America.

    About 30% of the people are believed to be the carrier of this

    pathogen

    bacterial growth may not cause any off color, odor, or textural

    or flavor change, but the toxin is secreted into the food.

    Incubation period:

    30 min-8 hrs usually 4-8 hrs

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    Transmission:

    Able to grow in wide range of temperature, pH 4.2-9.3 &

    sodium chloride concentrations, so is contained in wide range

    of food varieties

    Often this type of food poisoning occurs when cooked food is

    allowed to cool slowly and/or sit at room temperature for some

    time.

    Food at higger risk are those that are prepared by hand andrequire no cooking like pasteries, pudding, sliced meat etc.

    Transmitted by cuts, wound on skin. Human and animals are

    the primary reservoirs

    Susceptibility:

    Most of the people are susceptible to staphylococcus toxins

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    Diagnosis:

    Recovery of large no ofS.aureus (105organisms/g of food) on

    routine culture media or detection of enterotoxin from

    epidemiologically implicated food item confirms the diagnosis

    heat killed staphylococci in the food can be confirmed by gram

    stain of the heated food

    Isolation of organisms of the same type by pulsed field gelelectrophoresis from stools of two or more ill persons also

    confirms the diagnosis

    Control:Supportive therapy and fluid replacement may be provided

    when required

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    Educate food handlers in strict food hygiene, including

    cleanliness of kitchens, proper temperature control, hand

    washing, cleaning of fingernails and the danger of workingwith the exposed skin, nose and eye infections and the need to

    cover wounds.

    reduce food handling time to an absolute minimum, with not

    more than 4 hrs at ambient temperatureKeep perishable foods hot (> 60C) or cold (< 4C) in shallow

    containers and covered, if they are to be stored for more than 2

    hrs.

    Temporarily exclude people with boils, abcesses and otherpurulent lesions of hands, face or nose from food handling.

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    OUTBREAK One outbreak of staph food poisoning occurred at a convention

    in Chicago . A banquet meal included ham, potato salad, bakedbeans, rolls, chocolate cake and assorted drinks. Six hours after

    the meal, about one-third of the conventioneers developedcases of staph food poisoning.

    When the foods served were examined, the ham was found tobe highly contaminated with staph bacteria.

    CAUSE:

    The ham had been baked the day before and refrigeratedovernight. The next day, a cook with an infected cut on his

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    finger sliced the ham The sliced ham was stacked inlayers,wrapped in aluminum foil, warmed and held for severalhours before serving.

    ERRORS AND PREVENTIONS:

    First, the employee with the infected cut should have cleanedand covered it with a bandaid and glove.

    Second, the contaminated slices should not have been piled inlayers but spread so the heat could have penetrated and killedthe bacteria.

    Third, the sliced ham should not have been heated until just

    before serving, eliminating time for bacterial growth. It shouldhave been held hot, above 140 degrees F, which would haveprevented bacterial growth.

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    REFERENCES Estes Reynolds, George Schuler, William Hurst & P.T. Tybor, Preventing

    food poisoning and food infection, The University of Georgia College of

    Agricultural & Environmental Sciences

    Communicable disease management protocol, staphyloccocus food

    intoxication

    Text book of Food Borne diseases by Dean.O.Oliver, Academic Press,1990