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Food Borne Illness Food Borne Illness Food Borne Illness Can be caused by: • Food Borne Infections ( Living organisms ) • Food Borne Toxins ( non living chemicals ) Food Poisoning • Food Borne Toxins ( non living chemicals ) • Generated by Microbes Bacteria Fungi Algea • Man made toxins Agricultural residues Antibiotics Preservatives • Naturally occuring toxins Bacterial Food Poisoning Toxins that are destroyed by heating Clostridium botulinum Heat stable toxins Produced by bacteria Staphylococcus aureus Clostridium perfringens Bacillus cereus Food Borne Infections Causes by Bacteria that must grow in food before eaten • Require large infective dosage Only Bacteria Caused by Organism that do not have to grow in the food before it is eaten • Require small infective dosage Bacteria Viruses Parasites Staphylococcus aureus Staphylococcal Infections • Gram-positive cocci in irregular clusters • Coagulase negative strains make up to 90% of skin microbiota (S. epidermidis). Only pathogenic when skin is broken or through invasive entry. • Coagulase positive strains tend to be pathogenic. Almost all pathogenic S. aureus strains make coagulase. High correlation between ability to produce coagulase and production of damaging toxins: Leukocidin: Destroys phagocytic white blood cells. Exfoliative toxin: Responsible for scalded skin syndrome. Enterotoxins: Affect gastrointestinal tract. • S. aureus is commonly found in nasal passages. Staphylococcal Food Poisoning Characteristics: Acute onset of cramps, vomiting, nausea, occasional diarrhea, low body temperature and blood pressure. Recovery is usually complete within 24 hours. Mortality is low in healthy individuals, higher among immunosuppressed individuals. Pathogens: S. aureus strain that produces an enterotoxin. Reservoir: Human skin, nasal secretions, and cow milk. •On Manitol salt agar Heamolysis on HBA Staph Poisoning in USA 2000 Principal symptoms • Nausea, vomiting, retching, abdominal cramps, prostration Potential food contamination • Meat and meat products, poultry, egg • salads (chicken, potato, macaroni), • cream-filled bakery products, milk and dairy products No. of illnesses • 185,060 No. of deaths • 2 Micro & Macroscopic C. perfringens NOTE: Large rectangular NOTE: Double zone of hemolysis gram-positive bacilli Inner beta-hemolysis = θ toxin Outer alpha-hemolysis = α toxin Clostridial Cellulitis Exotoxins Associated with C. perfringens Types A-E Major Perfringens Poisoning in USA 2000 Principal symptoms Intense abdominal cramps, diarrhea Potential food contamination Meat, meat products, gravies No. of illnesses 248,520 No. of deaths 7 Clostridium perfringens Two syndromes – diarrhoea and ‘pig-bel’ (necrotizing enteritis) The organism – large, non- motile G+ve, anaerobic rod bacillus 2 forms – vegetative and sporeforming Strains – Type A (diarrhoea) - Type C (‘pig-bel’) Clostridium botulinum Principal symptoms • Weariness, weakness, vertigo, double vision, difficulty swallowing and speaking Potential food contamination Improperly canned or fermented goods No. of illnesses 58 No. of deaths 4 Clostridium botulinum Botulism & infant botulism (& wound botulism) The organism – anaerobic, G+ve, spore-forming rod Clostridium botulinum Group I – type A, B & F – food spoilage Group II – type B, E & F Types A, B, E & F – human botulism Types C & D – botulism in animals Clostridium botulinum Characteristics - grows anaerobically - spores & toxin resist freezing - spores resist desiccation Clostridium botulinum Pathogenesis - neurotoxin inhibits acetylcholine release - ultimately affects peripheral NS Clostridium botulinum Botulinum toxin inhibits acetylcholine release at neuromuscular junction Clostridium botulinum The illness, continued - infective dose – few nanograms - all individuals susceptible; infants <1yr - Rx – toxin removal, supportive Rx Clostridium botulinum Sources - human – no - animal – can be affected - food – Type E in seafood, Type A in vegetables, honey - environment – Types A, B & F in soils/sediments Type E – marine Dust (vacuum cleaner) Clostridium botulinum Outbreaks/sporadic cases Very rare in NZ – one case in 1984 – puha & mussels (incomplete lactic acid fermentation) Overseas: - roasted egg plant in oil, chopped garlic in oil, salted fish, tinned salmon, yoghurt, cheese & cheese sauce Bacillus cereus Principal symptoms • Diarrheal—watery diarrhea, abdominal cramps and pain • Emetic—nausea and vomiting Potential food contamination • Meats, milk, vegetables, fish 0 No. of illnesses • 27,360 No. of deaths •0 Bacillus cereus Two syndromes – diarrhoeal & emetic The organism – G+ve sporeforming rod Toxins – diarrhoeal & emetic Bacillus cereus Characteristics - rapid growth in food at 30-400C - vegetative cells killed by heat - spores resistant, emetic toxins resistant to heat