Transcript foodborne_disease-2_1

Food 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.
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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.
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.
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.
How eggs become contaminated
Salmonella enteritidis silently infects the ovaries of
healthy appearing hens and contaminates the eggs
before the shells are formed.
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.
How does Salmonella infect eggs
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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.
• 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 highrisk 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.
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.
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
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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
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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
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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 toxincontaining 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
Flushing, sweating, burning, peppery taste, dizzy, nausea,
headache, rash, diarrhea, stomach cramps
Scrombroid or
Histamine poisoning
occurs when
Scrombroid fish are
time/temp abused
Tuna, mackeral, bluefish, skipjack, swordfish, bonito
Shellfish Toxins (Intoxication)
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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!!!