Transcript Digestive Diseases

Diseases Acquired
through the
alimentary route
Botulism
Hemorrhagic colitis (Escherichia Coli 0157:H7)
Clostridium botulinum
 Gram-positive bacteria
 Rod shaped
 Most commonly found in the soil
 Spore forming
 Strict anaerobe
 Heat sensitive
 Prefers low acidic environment
Botulism
 Severe intoxication from the exotoxin produced by
Clostridium botulinum
 Results in a life-threatening paralytic illness
 Systemic illness
 When the toxin is ingested in contaminated food is
absorbed from the intestine into the system, it results in
the paralysis of cranial and peripheral nerves
Transmission
 Generally the result of eating foods that have been
inadequately cooked, allowing the toxin to form
 In the U.S. home canned fruit and vegetables have
been involved in most botulism cases
Outbreaks
 The largest botulism outbreaks in the U.S. in the past 19
yrs. occurred in El Paso, Texas: April 1994
 The toxin had formed in aluminum foil-wrapped baked
potatoes held at room temperature for several days
before they were used in a potato-based dip at a
restaurant
 30 people were affected and 4 required mechanical
ventilation
Symptoms
 The first signs generally relate to the effects of the toxin
on the nervous system
 Person may experience dizziness, difficulty in swallowing,
and double vision
 Nausea, vomiting, and diarrhea may occur earlier, ant
the same time or later
 Descending paralysis and death usually occurs from
respiratory paralysis
Treatment and Prevention
Prevention
Treatment
 Intramuscular (IM) or IV
administration of
botulinum antitoxin

Effective control of processing
and preparation of
commercially canned and
preserved foods

Educating everybody that
prepares and serves food

Any bulging cans or jars that
do not seem sealed should not
be opened or used

Potatoes which have been
baked while wrapped in
aluminum foil should be kept
hot until served or refrigerated
E. coli
E. Coli
 Gram negative
 Morphology: Straight rods
 Aerobic/Facultative anaerobic
 Not spore forming
 Non capsulated and motile
E. Coli
 E. coli is a normal inhabitant of the intestines of all
animals including humans
 Useful function in the body: suppresses the growth of
harmful bacterial species and helps in the synthesis of
vitamins
 Only some E. coli are pathogenic
 Cause either diarrhea or illness outside the intestinal wall
E. coli
 Consists of a diverse group of bacteria
 Pathogenic E. coli strains are categorized into pathotypes
 Six pathotypes are associated with diarrhea
 EHEC- enterohemorrhagic E. coli: hemorrhagic colitis or hemolytic
uremic syndrome
 Also referred to as Shiga toxin producing E. coli (STEC)
 ETEC- enterotoxogenic E. coli- traveler’s diarrhea
 EPEC- enteropathogenic E. coli- childhood diarrhea
 EIEC- enteroinvasive E. coli- Shigella like dysentery
 EAEC- eteroadherent E. coli- childhood diarrhea, some cases of
traveler’s diarrhea
 EAggEC- enteroaggregative E. coli- persistent diarrhea in
developing countries
Transmission
Organism responsible for hemorrhagic
colitis: Escherichia coli 0157:H7
 By ingestion of contaminated food or water
 Person to person
 Organism can be found in hamburger and other
meats
 different sources including apple juice, coleslaw, jerky
made from dear meat, and alfalfa sprouts
http://www.cdc.gov/ecoli/2012/O157H7-1112/index.html
Symptoms
 Severe cramping and diarrhea are the first symptoms
 Diarrhea is watery at first, but in most victims, becomes
bloody
 Occasional vomiting
 Low grade fever or none at all
 Illness lasts and avg. of 8 days
Treatment
 Most cases require not therapy, but fluid replacement
may be necessary
 Some evidence has shown that antibiotic treatment
can increase the risk of complications, but further
investigation needs to be done
Prevention

Families of people who are ill need to be educated about possible
person-to person transmission

“Ten Golden Rules for Food Preparation” by WHO
 Choose food processed for safety
 Cook food thoroughly
 Eat cooked food immediately
 Store cooked food carefully
 Reheat cooked foods thoroughly
 Avoid contact between raw and cooked foods
 What hands repeatedly
 Keep all kitchen surfaces meticulously clean
 Protect foods from insects, rodents, and other animals
 Use pure water