Foodborne illness (also foodborne disease and food poisoning) is any
illness resulting from the spoilage of
contaminated food by
pathogenic
bacteria,
viruses, or
parasites that contaminate food,
[
] as well as
prions (the agents of
mad cow disease), and
toxins such as
aflatoxins in peanuts,
poisonous mushrooms, and various species of
beans that have not been boiled for at least 10 minutes.
Symptoms vary depending on the cause but often include vomiting, fever, and aches, and may include
diarrhea. Bouts of vomiting can be repeated with an extended delay in between, because even if infected food was eliminated from the stomach in the first bout,
microbe
A microorganism, or microbe,, ''mikros'', "small") and ''organism'' from the el, ὀργανισμός, ''organismós'', "organism"). It is usually written as a single word but is sometimes hyphenated (''micro-organism''), especially in olde ...
s, like
bacteria (if applicable), can pass through the
stomach into the
intestine
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
and begin to multiply. Some types of microbes stay in the intestine.
For contaminants requiring an
incubation period, symptoms may not manifest for hours to days, depending on the cause and on quantity of consumption. Longer incubation periods tend to cause those affected to not associate the symptoms with the item consumed, so they may misattribute the symptoms to
gastroenteritis
Gastroenteritis, also known as infectious diarrhea and gastro, is an inflammation of the gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydra ...
, for example.
Causes
Foodborne illness usually arises from improper handling, preparation, or
food storage
Food storage is a way of decreasing the variability of the food supply in the face of natural, inevitable variability. p.507 It allows food to be eaten for some time (typically weeks to months) after harvest rather than solely immediately. I ...
. Good
hygiene practices before, during, and after food preparation can reduce the chances of contracting an illness. There is a consensus in the public health community that regular hand-washing is one of the most effective defenses against the spread of foodborne illness. The action of monitoring food to ensure that it will not cause foodborne illness is known as
food safety
Food safety (or food hygiene) is used as a scientific method/discipline describing handling, preparation, and storage of food in ways that prevent food-borne illness. The occurrence of two or more cases of a similar illness resulting from t ...
. Foodborne disease can also be caused by a large variety of toxins that affect the environment.
Furthermore, foodborne illness can be caused by a number of chemicals, such as
pesticide
Pesticides are substances that are meant to control pests. This includes herbicide, insecticide, nematicide, molluscicide, piscicide, avicide, rodenticide, bactericide, insect repellent, animal repellent, microbicide, fungicide, and lampri ...
s,
medicines, and natural toxic substances such as vomitoxin,
poisonous mushrooms or
reef fish.
Bacteria
Bacteria are a common cause of foodborne illness. The
United Kingdom, in 2000, reported the individual bacteria involved as the following: ''
Campylobacter jejuni'' 77.3%, ''
Salmonella
''Salmonella'' is a genus of rod-shaped (bacillus) Gram-negative bacteria of the family Enterobacteriaceae. The two species of ''Salmonella'' are ''Salmonella enterica'' and ''Salmonella bongori''. ''S. enterica'' is the type species and is fur ...
'' 20.9%,
''Escherichia coli'' O157:H7 1.4%, and all others less than 0.56%.
In the past, bacterial infections were thought to be more prevalent because few places had the capability to test for
norovirus and no active surveillance was being done for this particular agent. Toxins from bacterial infections are delayed because the bacteria need time to multiply. As a result, symptoms associated with intoxication are usually not seen until 12–72 hours or more after eating contaminated food. However, in some cases, such as Staphylococcal food poisoning, the onset of illness can be as soon as 30 minutes after ingesting contaminated food.
A 2022 study concluded that washing uncooked chicken could increase risk pathogen transfer, and that specific washing conditions can decrease the risk of transfer.
Most common bacterial foodborne pathogens are:
* ''
Campylobacter jejuni'' which can lead to secondary
Guillain–Barré syndrome and
periodontitis
* ''
Clostridium perfringens'', the "cafeteria germ"
[
]
* ''
Salmonella
''Salmonella'' is a genus of rod-shaped (bacillus) Gram-negative bacteria of the family Enterobacteriaceae. The two species of ''Salmonella'' are ''Salmonella enterica'' and ''Salmonella bongori''. ''S. enterica'' is the type species and is fur ...
''
spp. – its ''S. typhimurium'' infection is caused by consumption of eggs or poultry that are not adequately cooked or by other interactive human-animal pathogens
[
]
* ''
Escherichia coli O157:H7'' enterohemorrhagic (EHEC) which can cause
hemolytic-uremic syndrome
Other common bacterial foodborne pathogens are:
* ''
Bacillus cereus''
* ''
Escherichia coli'', other
virulence properties, such as enteroinvasive (EIEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroaggregative (EAEC or EAgEC)
* ''
Listeria monocytogenes''
* ''
Shigella'' spp.
* ''
Staphylococcus aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
''
* ''
Staphylococcal enteritis''
* ''
Streptococcus''
* ''
Vibrio cholerae'', including O1 and non-O1
* ''
Vibrio parahaemolyticus''
* ''
Vibrio vulnificus''
* ''
Yersinia enterocolitica'' and ''
Yersinia pseudotuberculosis''
Less common bacterial agents:
* ''
Brucella'' spp.
* ''
Corynebacterium ulcerans''
* ''
Coxiella burnetii'' or Q fever
* ''
Plesiomonas shigelloides''
Enterotoxins
In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by
enterotoxins (
exotoxin
An exotoxin is a toxin secreted by bacteria. An exotoxin can cause damage to the host by destroying cells or disrupting normal cellular metabolism. They are highly potent and can cause major damage to the host. Exotoxins may be secreted, or, simi ...
s targeting the intestines). Enterotoxins can produce illness even when the microbes that produced them have been killed. Symptom appearance varies with the toxin but may be rapid in onset, as in the case of enterotoxins of ''
Staphylococcus aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'' in which symptoms appear in one to six hours. This causes intense
vomiting including or not including diarrhea (resulting in
staphylococcal enteritis), and staphylococcal enterotoxins (most commonly
staphylococcal enterotoxin A but also including
staphylococcal enterotoxin B) are the most commonly reported enterotoxins although cases of poisoning are likely underestimated.
It occurs mainly in cooked and processed foods due to competition with other biota in raw foods, and humans are the main cause of contamination as a substantial percentage of humans are persistent carriers of ''S. aureus''.
[ The CDC has estimated about 240,000 cases per year in the United States.
* '' Clostridium botulinum''
* '' Clostridium perfringens''
* '' Bacillus cereus''
The rare but potentially deadly disease botulism occurs when the anaerobic bacterium '' Clostridium botulinum'' grows in improperly canned low-acid foods and produces ]botulin
Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium ''Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromusc ...
, a powerful paralytic toxin.
''Pseudoalteromonas tetraodonis'', certain species of Pseudomonas and Vibrio, and some other bacteria, produce the lethal tetrodotoxin, which is present in the tissues of some living animal species rather than being a product of decomposition.
Emerging foodborne pathogens
* '' Aeromonas hydrophila'', ''Aeromonas caviae'', ''Aeromonas sobria''
Scandinavian outbreaks of '' Yersinia enterocolitica'' have recently increased to an annual basis, connected to the non-canonical contamination of pre-washed salad.
Preventing bacterial food poisoning
Prevention is mainly the role of the state, through the definition of strict rules of hygiene and a public services of veterinary surveying of animal products in the food chain, from farming to the transformation industry and delivery (shops and restaurant
A restaurant is a business that prepares and serves food and drinks to customers. Meals are generally served and eaten on the premises, but many restaurants also offer take-out and food delivery services. Restaurants vary greatly in appearan ...
s). This regulation includes:
* traceability: in a final product, it must be possible to know the origin of the ingredients (originating farm, identification of the harvesting or of the animal) and where and when it was processed; the origin of the illness can thus be tracked and solved (and possibly penalized), and the final products can be removed from the sale if a problem is detected;
* enforcement of hygiene procedures such as HACCP and the " cold chain";
* power of control and of law enforcement of veterinarians.
In August 2006, the United States Food and Drug Administration approved phage therapy which involves spraying meat with viruses that infect bacteria, and thus preventing infection. This has raised concerns, because without mandatory labelling consumers would not be aware that meat and poultry products have been treated with the spray.
At home, prevention mainly consists of good food safety
Food safety (or food hygiene) is used as a scientific method/discipline describing handling, preparation, and storage of food in ways that prevent food-borne illness. The occurrence of two or more cases of a similar illness resulting from t ...
practices. Many forms of bacterial poisoning can be prevented by cooking food sufficiently, and either eating it quickly or refrigerating it effectively.[ Many toxins, however, are not destroyed by heat treatment.
Techniques that help prevent food borne illness in the kitchen are hand washing, rinsing produce, preventing cross-contamination, proper storage, and maintaining cooking temperatures. In general, freezing or refrigerating prevents virtually all bacteria from growing, and heating food sufficiently kills parasites, viruses, and most bacteria. Bacteria grow most rapidly at the range of temperatures between , called the "danger zone". Storing food below or above the "danger zone" can effectively limit the production of toxins. For storing leftovers, the food must be put in shallow containers
for quick cooling and must be refrigerated within two hours. When food is reheated, it must reach an internal temperature of or until hot or steaming to kill bacteria.
]
Mycotoxins and alimentary mycotoxicoses
The term alimentary mycotoxicosis
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
refers to the effect of poisoning by mycotoxins through food consumption. The term mycotoxin is usually reserved for the toxic chemical products produced by fungi that readily colonize crops. Mycotoxins sometimes have important effects on human and animal health. For example, an outbreak which occurred in the UK in 1960 caused the death of 100,000 turkeys which had consumed aflatoxin-contaminated peanut meal. In the USSR in World War II, 5,000 people died due to alimentary toxic aleukia
Alimentary toxic aleukia is a mycotoxin-induced condition characterized by nausea, vomiting, diarrhea, leukopenia (aleukia), hemorrhaging, skin inflammation, and sometimes death. Alimentary toxic aleukia almost always refers to the human condition ...
(ALA). The common foodborne Mycotoxins include:
* Aflatoxins – originating from '' Aspergillus parasiticus'' and '' Aspergillus flavus''. They are frequently found in tree nuts, peanuts, maize, sorghum and other oilseeds, including corn and cottonseeds. The pronounced forms of Aflatoxins are those of B1, B2, G1, and G2, amongst which Aflatoxin B1 predominantly targets the liver, which will result in necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated dige ...
, cirrhosis, and carcinoma
Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesodermal ...
.[
] In the US, the acceptable level of total aflatoxins in foods is less than 20 μg/kg, except for Aflatoxin M1 in milk, which should be less than 0.5 μg/kg.[
] The official document can be found at FDA's website.
* Altertoxins – are those of alternariol (AOH), alternariol methyl ether (AME), altenuene (ALT), altertoxin-1 (ATX-1), tenuazonic acid (TeA), and radicinin
Radicinin is a phytotoxin with the molecular formula C12H12O5. Radicinin is produced by the fungal plant pathogen ''Alternaria radicina'' and other ''Alternaria'' species.
References
Further reading
*
Radicinin
Radicinin is a phytotox ...
(RAD), originating from '' Alternaria'' spp. Some of the toxins can be present in sorghum, ragi, wheat and tomatoes.[
] Some research has shown that the toxins can be easily cross-contaminated between grain commodities, suggesting that manufacturing and storage of grain commodities is a critical practice.[
]
* Citrinin
Citrinin is a mycotoxin which is often found in food. It is a secondary metabolite produced by fungi that contaminates long-stored food and it causes different toxic effects, like nephrotoxic, hepatotoxic and cytotoxic effects. Citrinin is mainly ...
* Citreoviridin
* Cyclopiazonic acid
Cyclopiazonic acid (α-CPA), a mycotoxin and a fungal neurotoxin, is made by the molds '' Aspergillus'' and '' Penicillium''. It is an indole-tetramic acid that serves as a toxin due to its ability to inhibit calcium-dependent ATPases found in th ...
* Cytochalasins
* Ergot alkaloids / ergopeptine alkaloids
Alkaloids are a class of basic, naturally occurring organic compounds that contain at least one nitrogen atom. This group also includes some related compounds with neutral and even weakly acidic properties. Some synthetic compounds of similar st ...
– ergotamine
* Fumonisins – Crop corn can be easily contaminated by the fungi '' Fusarium moniliforme'', and its fumonisin B1 will cause leukoencephalomalacia (LEM) in horses, pulmonary edema syndrome
The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of th ...
(PES) in pigs, liver cancer in rats and esophageal cancer
Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach. Symptoms often include difficulty in swallowing and weight loss. Other symptoms may include pain when swallowing, a hoarse voice ...
in humans. For human and animal health, both the FDA and the EC have regulated the content levels of toxins in food and animal feed.
* Fusaric acid
* Fusarochromanone
* Kojic acid
* Lolitrem alkaloids
* Moniliformin
* 3-Nitropropionic acid
* Nivalenol
* Ochratoxins – In Australia, The Limit of Reporting (LOR) level for ochratoxin A (OTA) analyses in 20th Australian Total Diet Survey was 1 µg/kg, whereas the EC restricts the content of OTA to 5 µg/kg in cereal commodities, 3 µg/kg in processed products and 10 µg/kg in dried vine fruits.
* Oosporeine
* Patulin – Currently, this toxin has been advisably regulated on fruit products. The EC and the FDA have limited it to under 50 µg/kg for fruit juice and fruit nectar, while limits of 25 µg/kg for solid-contained fruit products and 10 µg/kg for baby foods were specified by the EC.
* Phomopsins
* Sporidesmin A
* Sterigmatocystin
* Tremorgenic mycotoxins – Five of them have been reported to be associated with molds found in fermented meats. These are fumitremorgen B, paxilline, penitrem A, verrucosidin, and verruculogen
Verruculogen is a mycotoxin produced by certain strains of ''aspergillus'' that belongs to a class of naturally occurring 2,5-diketopiperazines. It is an annulated analogue of cyclo(L-Trp-L-Pro) which belongs to the most abundant and structurall ...
.
* Trichothecenes – sourced from ''Cephalosporium'', '' Fusarium'', ''Myrothecium'', ''Stachybotrys
''Stachybotrys'' () is a genus of molds, hyphomycetes or asexually reproducing, filamentous fungi, now placed in the family Stachybotryaceae. The genus was erected by August Carl Joseph Corda in 1837. Historically, it was considered closely re ...
'', and ''Trichoderma
''Trichoderma'' is a genus of fungi in the family Hypocreaceae that is present in all soils, where they are the most prevalent culturable fungi. Many species in this genus can be characterized as opportunistic avirulent plant symbionts. This ...
''. The toxins are usually found in molded maize, wheat, corn, peanuts and rice, or animal feed of hay and straw.[
] Four trichothecenes, T-2 toxin, HT-2 toxin, diacetoxyscirpenol (DAS), and deoxynivalenol
Vomitoxin, also known as deoxynivalenol (DON), is a type B trichothecene, an epoxy-sesquiterpenoid. This mycotoxin occurs predominantly in grains such as wheat, barley, oats, rye, and corn, and less often in rice, sorghum, and triticale. The occ ...
(DON) have been most commonly encountered by humans and animals. The consequences of oral intake of, or dermal exposure to, the toxins will result in alimentary toxic aleukia, neutropenia
Neutropenia is an abnormally low concentration of neutrophils (a type of white blood cell) in the blood. Neutrophils make up the majority of circulating white blood cells and serve as the primary defense against infections by destroying bacteria ...
, aplastic anemia
Aplastic anemia is a cancer in which the body fails to make blood cells in sufficient numbers. Blood cells are produced in the bone marrow by stem cells that reside there. Aplastic anemia causes a deficiency of all blood cell types: red blood ...
, thrombocytopenia and/or skin irritation. In 1993, the FDA issued a document for the content limits of DON in food and animal feed at an advisory level. In 2003, US published a patent that is very promising for farmers to produce a trichothecene-resistant crop.[Hohn, Thomas M. "Trichothecene-resistant transgenic plants". . Priority date March 31, 1999.]
* Zearalenone
* Zearalenols
Viruses
Viral
Viral means "relating to viruses" (small infectious agents).
Viral may also refer to:
Viral behavior, or virality
Memetic behavior likened that of a virus, for example:
* Viral marketing, the use of existing social networks to spread a marke ...
infections make up perhaps one third of cases of food poisoning in developed countries. In the US, more than 50% of cases are viral and noroviruses
Norovirus, sometimes referred to as the winter vomiting disease, is the most common cause of gastroenteritis. Infection is characterized by non-bloody diarrhea, vomiting, and stomach pain. Fever or headaches may also occur. Symptoms usually dev ...
are the most common foodborne illness, causing 57% of outbreaks in 2004. Foodborne viral infection are usually of intermediate (1–3 days) incubation period, causing illnesses which are self-limited in otherwise healthy individuals; they are similar to the bacterial forms described above.
* Enterovirus
* Hepatitis A is distinguished from other viral causes by its prolonged (2–6 week) incubation period and its ability to spread beyond the stomach and intestines into the liver. It often results in jaundice
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme meta ...
, or yellowing of the skin, but rarely leads to chronic liver dysfunction. The virus has been found to cause infection due to the consumption of fresh-cut produce which has fecal contamination.[
]
* Hepatitis E
* Norovirus
* Rotavirus
Parasites
Most foodborne parasites are zoonoses.
* Platyhelminthes:
** ''Diphyllobothrium
''Diphyllobothrium'' is a genus of tapeworms which can cause diphyllobothriasis in humans through consumption of raw or undercooked fish. The principal species causing diphyllobothriasis is ''D. latum'', known as the broad or fish tapeworm, or b ...
'' sp.
** ''Nanophyetus'' sp.
** '' Taenia saginata''
** '' Taenia solium''
** '' Fasciola hepatica''
**See also: Tapeworm and Flatworm
The flatworms, flat worms, Platyhelminthes, or platyhelminths (from the Greek πλατύ, ''platy'', meaning "flat" and ἕλμινς (root: ἑλμινθ-), ''helminth-'', meaning "worm") are a phylum of relatively simple bilaterian, unsegment ...
* Nematode
The nematodes ( or grc-gre, Νηματώδη; la, Nematoda) or roundworms constitute the phylum Nematoda (also called Nemathelminthes), with plant-Parasitism, parasitic nematodes also known as eelworms. They are a diverse animal phylum inhab ...
:
** '' Anisakis'' sp.
** '' Ascaris lumbricoides''
** '' Eustrongylides'' sp.
** '' Toxocara''
** '' Trichinella spiralis''
** '' Trichuris trichiura''
* Protozoa
Protozoa (singular: protozoan or protozoon; alternative plural: protozoans) are a group of single-celled eukaryotes, either free-living or parasitic, that feed on organic matter such as other microorganisms or organic tissues and debris. Histo ...
:
** '' Acanthamoeba'' and other free-living amoebae
** '' Cryptosporidiosis''
** '' Cyclospora cayetanensis''
** '' Entamoeba histolytica''
** '' Giardia lamblia''
** ''Sarcocystis hominis''
** ''Sarcocystis suihominis''
** '' Toxoplasma''
Natural toxins
Several foods can naturally contain toxins
A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849–1 ...
, many of which are not produced by bacteria. Plants in particular may be toxic; animals which are naturally poisonous to eat are rare. In evolutionary terms, animals can escape being eaten by fleeing; plants can use only passive defenses such as poisons and distasteful substances, for example capsaicin in chili peppers and pungent sulfur
Sulfur (or sulphur in British English) is a chemical element with the symbol S and atomic number 16. It is abundant, multivalent and nonmetallic. Under normal conditions, sulfur atoms form cyclic octatomic molecules with a chemical formula ...
compounds in garlic
Garlic (''Allium sativum'') is a species of bulbous flowering plant in the genus ''Allium''. Its close relatives include the onion, shallot, leek, chive, Allium fistulosum, Welsh onion and Allium chinense, Chinese onion. It is native to South A ...
and onions. Most animal poisons are not synthesised by the animal, but acquired by eating poisonous plants to which the animal is immune, or by bacterial action.
* Alkaloids
* Ciguatera poisoning
* Grayanotoxin (honey
Honey is a sweet and viscous substance made by several bees, the best-known of which are honey bees. Honey is made and stored to nourish bee colonies. Bees produce honey by gathering and then refining the sugary secretions of plants (primar ...
intoxication)
* Hormones from the thyroid gland
The thyroid, or thyroid gland, is an endocrine gland in vertebrates. In humans it is in the neck and consists of two connected lobe (anatomy), lobes. The lower two thirds of the lobes are connected by a thin band of Connective tissue, tissue cal ...
s of slaughtered animals (especially Triiodothyronine in cases of ''hamburger thyrotoxicosis'' or ''alimentary thyrotoxicosis'')
* Mushroom toxins
* Phytohaemagglutinin (red kidney bean
The kidney bean is a variety of the common bean (''Phaseolus vulgaris''). It resembles a human kidney and thus is named after such. Red kidney beans should not be confused with other red beans, such as adzuki beans.
Classification
There are d ...
poisoning; destroyed by boiling)
* Pyrrolizidine alkaloid
Pyrrolizidine alkaloids (PAs), sometimes referred to as necine bases, are a group of naturally occurring alkaloids based on the structure of pyrrolizidine. Pyrrolizidine alkaloids are produced by plants as a defense mechanism against insect he ...
s
* Shellfish toxin, including paralytic shellfish poisoning, diarrhetic shellfish poisoning, neurotoxic shellfish poisoning, amnesic shellfish poisoning and ciguatera fish poisoning
* Scombrotoxin
Scombroid food poisoning, also known as simply scombroid, is a foodborne illness that typically results from eating spoiled fish. Symptoms may include flushed skin, headache, itchiness, blurred vision, abdominal cramps, and diarrhea. Onset of sym ...
* Tetrodotoxin ( fugu fish poisoning)
Some plants contain substances which are toxic in large doses, but have therapeutic properties in appropriate dosages.
* Foxglove contains cardiac glycosides.
* Poisonous hemlock ( conium) has medicinal uses.
Other pathogenic agents
* Prion
Prions are misfolded proteins that have the ability to transmit their misfolded shape onto normal variants of the same protein. They characterize several fatal and transmissible neurodegenerative diseases in humans and many other animals. It ...
s, resulting in Creutzfeldt–Jakob disease (CJD) and its variant ( vCJD)
"Ptomaine poisoning"
Ptomaine poisoning was a myth that persisted in the public consciousness, in newspaper headlines, and legal cases as an official diagnosis, decades after it had been disproven scientifically in the 1910s.
In the 19th century, the Italian chemist Francesco Selmi, of Bologna, introduced the generic name ' (from Greek ''ptōma'', "fall, fallen body, corpse") for alkaloids found in decaying animal and vegetable matter, especially (as reflected in their names) putrescine and cadaverine. The 1892 ''Merck's Bulletin'' stated, "We name such products of bacterial origin ptomaines; and the special alkaloid produced by the comma bacillus is variously named Cadaverine, Putrescine, etc." While '' The Lancet'' stated, "The chemical ferments produced in the system, the... ptomaines which may exercise so disastrous an influence." It is now known that the "disastrous... influence" is due to the direct action of bacteria and only slightly due to the alkaloids. Thus, the use of the phrase "ptomaine poisoning" is now obsolete.
Tainted potato salad sickening hundreds at a Communist
Communism (from Latin la, communis, lit=common, universal, label=none) is a far-left sociopolitical, philosophical, and economic ideology and current within the socialist movement whose goal is the establishment of a communist society, a s ...
political convention in Massillon, Ohio
Massillon is a city in Stark County, Ohio, Stark County in the U.S. state of Ohio, approximately west of Canton, Ohio, Canton, south of Akron, and south of Cleveland. The population was 32,146 at the 2020 United States Census, 2020 census. Mass ...
, and aboard a Washington DC cruise boat in separate incidents during a single week in 1932 drew national attention to the dangers of so-called "ptomaine poisoning" in the pages of the American news weekly, '' Time.''
Another newspaper article from 1944 told of more than 150 persons being hospitalized in Chicago with ptomaine poisoning apparently from rice pudding served by a chain of restaurants.
Mechanism
Incubation period
The delay between the consumption of contaminated food and the appearance of the first symptom
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
s of illness is called the incubation period. This ranges from hours to days (and rarely months or even years, such as in the case of listeriosis or bovine spongiform encephalopathy), depending on the agent, and on how much was consumed. If symptoms occur within one to six hours after eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than live bacteria.
The long incubation period of many foodborne illnesses tends to cause those affected to attribute their symptoms to gastroenteritis
Gastroenteritis, also known as infectious diarrhea and gastro, is an inflammation of the gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydra ...
.
During the incubation period, microbe
A microorganism, or microbe,, ''mikros'', "small") and ''organism'' from the el, ὀργανισμός, ''organismós'', "organism"). It is usually written as a single word but is sometimes hyphenated (''micro-organism''), especially in olde ...
s pass through the stomach into the intestine
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
, attach to the cells
Cell most often refers to:
* Cell (biology), the functional basic unit of life
Cell may also refer to:
Locations
* Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery w ...
lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a toxin that is absorbed into the bloodstream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe.
Infectious dose
The infectious dose
The concept of minimal infective dose (MID) has traditionally been used for infectious bacteria that contaminate foods. MID was defined as the number of bacteria ingested (the dose) from which a pathology is observed in the consumer. Examples such ...
is the amount of agent that must be consumed to give rise to symptoms of foodborne illness, and varies according to the agent and the consumer's age and overall health. Pathogens vary in minimum infectious dose; for example, '' Shigella sonnei'' has a low estimated minimum dose of < 500 colony-forming units (CFU) while ''Staphylococcus aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'' has a relatively high estimate.
In the case of ''Salmonella
''Salmonella'' is a genus of rod-shaped (bacillus) Gram-negative bacteria of the family Enterobacteriaceae. The two species of ''Salmonella'' are ''Salmonella enterica'' and ''Salmonella bongori''. ''S. enterica'' is the type species and is fur ...
'' a relatively large inoculum of 1 million to 1 billion organisms is necessary to produce symptoms in healthy human volunteers, as ''Salmonellae'' are very sensitive to acid. An unusually high stomach pH level (low acidity) greatly reduces the number of bacteria required to cause symptoms by a factor of between 10 and 100.
Gut microbiota unaccustomed to endemic organisms
Foodborne illness often occurs as travelers' diarrhea
Travelers' diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage of unformed stool (one or more by some definitions, three or more by others) while traveling. It may be accompanied by abdominal cramps, nausea, fever, ...
in persons whose gut microbiota
Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses that live in the digestive tracts of animals. The gastrointestinal metagenome is the aggregate of all the genomes of the gut m ...
is unaccustomed to organisms endemic to the visited region. This effect of microbiologic naïveté is compounded by any food safety
Food safety (or food hygiene) is used as a scientific method/discipline describing handling, preparation, and storage of food in ways that prevent food-borne illness. The occurrence of two or more cases of a similar illness resulting from t ...
lapses in the food's preparation.
Epidemiology
Asymptomatic subclinical infection may help spread these diseases, particularly ''Staphylococcus aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'', ''Campylobacter
''Campylobacter'' (meaning "curved bacteria") is a genus of Gram-negative bacteria. ''Campylobacter'' typically appear comma- or s-shaped, and are motile. Some ''Campylobacter'' species can infect humans, sometimes causing campylobacteriosis, a d ...
, Salmonella
''Salmonella'' is a genus of rod-shaped (bacillus) Gram-negative bacteria of the family Enterobacteriaceae. The two species of ''Salmonella'' are ''Salmonella enterica'' and ''Salmonella bongori''. ''S. enterica'' is the type species and is fur ...
, Shigella, Enterobacter, Vibrio cholerae,'' and ''Yersinia''. For example, as of 1984 it was estimated that in the United States, 200,000 people were asymptomatic carriers of ''Salmonella''.
Infants
Globally, infants are a group that is especially vulnerable to foodborne disease. The World Health Organization has issued recommendations for the preparation, use and storage of prepared formulas. Breastfeeding remains the best preventive measure for protection from foodborne infections in infants.
United States
In the United States, using FoodNet data from 2000 to 2007, the CDC estimated there were 47.8 million foodborne illnesses per year (16,000 cases for 100,000 inhabitants) with 9.4 million of these caused by 31 known identified pathogens.
* 127,839 were hospitalized (43 per 100,000 inhabitants per year).
* 3,037 people died (1.0 per 100,000 inhabitants per year).[
]
United Kingdom
According to a 2012 report from the Food Standards Agency, there were around a million cases of foodborne illness per year (1,580 cases for 100,000 inhabitants).
* 20,000 were hospitalized (32 per 100,000 inhabitants);
* 500 people died (0.80 per 100,000 inhabitants).
France
This data pertains to reported medical cases of 23 specific pathogens in the 1990s, as opposed to total population estimates of all foodborne illness for the United States.
In France, for 750,000 cases (1,210 per 100,000 inhabitants):
* 70,000 people consulted in the emergency department of a hospital (113 per 100,000 inhabitants);
* 113,000 people were hospitalized (182 per 100,000 inhabitants);
* 460 people died (0.75 per 100,000 inhabitants).
Australia
A study by the Australian National University, published in November 2014, found in 2010 that there were an estimated 4.1 million cases of foodborne gastroenteritis acquired in Australia on average each year, along with 5,140 cases of non-gastrointestinal illness. The study was funded by the Australian Department of Health, Food Standards Australia New Zealand and the NSW Food Authority.
The main causes were Norovirus, pathogenic Escherichia coli, Campylobacter spp. and non-typhoidal Salmonella spp., although the causes of approximately 80% of illnesses were unknown. Approximately 25% (90% CrI: 13%–42%) of the 15.9 million episodes of gastroenteritis that occur in Australia were estimated to be transmitted by contaminated food. This equates to an average of approximately one episode of foodborne gastroenteritis every five years per person. Data on the number of hospitalisations and deaths represent the occurrence of serious foodborne illness. Including gastroenteritis, non-gastroenteritis and sequelae, there were an estimated annual 31,920 (90% CrI: 29,500–35,500) hospitalisations due to foodborne illness and 86 (90% CrI: 70–105) deaths due to foodborne illness circa 2010. This study concludes that these rates are similar to recent estimates in the US and Canada.
A main aim of this study was to compare if foodborne illness incidence had increased over time. In this study, similar methods of assessment were applied to data from circa 2000, which showed that the rate of foodborne gastroenteritis had not changed significantly over time. Two key estimates were the total number of gastroenteritis episodes each year, and the proportion considered foodborne. In circa 2010, it was estimated that 25% of all episodes of gastroenteritis were foodborne. By applying this proportion of episodes due to food to the incidence of gastroenteritis circa 2000, there were an estimated 4.3 million (90% CrI: 2.2–7.3 million) episodes of foodborne gastroenteritis circa 2000, although credible intervals overlap with 2010. Taking into account changes in population size, applying these equivalent methods suggests a 17% decrease in the rate of foodborne gastroenteritis between 2000 and 2010, with considerable overlap of the 90% credible intervals.
This study replaces a previous estimate of 5.4 million cases of foodborne illness in Australia every year, causing:
* 18,000 hospitalizations
* 120 deaths (0.5 deaths per 100,000 inhabitants)
* 2.1 million lost days off work
* 1.2 million doctor consultations
* 300,000 prescriptions for antibiotics.
Most foodborne disease outbreaks in Australia have been linked to raw or minimally cooked eggs or poultry. The Australian Food Safety Information Council The Australian Food Safety Information Council is a health promotion charity. The Council develops consumer-targeted food safety information to address the estimated 4.1 million cases of food poisoning in Australia each year that result in 31,920 ho ...
estimates that one third of cases of food poisoning occur in the home.
Comparison between countries
Outbreaks
The vast majority of reported cases of foodborne illness occur as individual or sporadic cases. The origin of most sporadic cases is undetermined. In the United States, where people eat outside the home frequently, 58% of cases originate from commercial food facilities (2004 FoodNet data). An outbreak is defined as occurring when two or more people experience similar illness after consuming food from a common source.
Often, a combination of events contributes to an outbreak, for example, food might be left at room temperature for many hours, allowing bacteria to multiply which is compounded by inadequate cooking which results in a failure to kill the dangerously elevated bacterial levels.
Outbreaks are usually identified when those affected know each other. Outbreaks can also be identified by public health staff when there are unexpected increases in laboratory results for certain strains of bacteria. Outbreak detection and investigation in the United States is primarily handled by local health jurisdictions and is inconsistent from district to district. It is estimated that 1–2% of outbreaks are detected.
Society and culture
United Kingdom
In postwar Aberdeen (1964) a large-scale (>400 cases) outbreak of typhoid occurred, caused by contaminated corned beef
Corned beef, or salt beef in some of the Commonwealth of Nations, is Salt-cured meat, salt-cured brisket of beef. The term comes from the treatment of the meat with large-grained rock salt, also called "corns" of salt. Sometimes, sugar and sp ...
which had been imported from Argentina. The corned beef was placed in cans and because the cooling plant had failed, cold river water from the Plate estuary was used to cool the cans. One of the cans had a defect and the meat inside was contaminated. This meat was then sliced using a meat slicer in a shop in Aberdeen, and a lack of cleaning the machinery led to spreading the contamination to other meats cut in the slicer. These meats were then eaten by the people of Aberdeen who then became ill.
Serious outbreaks of foodborne illness since the 1970s prompted key changes in UK food safety
Food safety (or food hygiene) is used as a scientific method/discipline describing handling, preparation, and storage of food in ways that prevent food-borne illness. The occurrence of two or more cases of a similar illness resulting from t ...
law. These included the death of 19 patients in the Stanley Royd Hospital outbreak and the bovine spongiform encephalopathy (BSE, mad cow disease) outbreak identified in the 1980s. The death of 21 people in the 1996 Wishaw outbreak
File:1996 Events Collage.png, From left, clockwise: A Centennial Olympic Park bombing, bomb explodes at Centennial Olympic Park in Atlanta, set off by a radical Anti-abortion violence, anti-abortionist; The center fuel tank explodes on TWA Flight 8 ...
of ''E. coli'' O157 was a precursor to the establishment of the Food Standards Agency which, according to Tony Blair in the 1998 white paper ''A Force for Change'' Cm 3830, "would be powerful, open and dedicated to the interests of consumers".
In May 2015, for the second year running, England's Food Standards Agency devoted its annual Food Safety Week to – "The Chicken Challenge". The focus was on the handling of raw chicken in the home and in catering facilities in a drive to reduce the high levels of food poisoning from the ''campylobacter'' bacterium. Anne Hardy argues that widespread public education of food hygiene can be useful, particularly through media (TV cookery programmes) and advertisement. She points to the examples set by Scandinavian societies.
United States
In 2001, the Center for Science in the Public Interest petitioned the United States Department of Agriculture to require meat packers to remove spinal cords before processing cattle carcasses for human consumption, a measure designed to lessen the risk of infection by variant Creutzfeldt–Jakob disease. The petition was supported by the American Public Health Association, the Consumer Federation of America, the Government Accountability Project, the National Consumers League, and Safe Tables Our Priority.
None of the US Department of Health and Human Services targets regarding incidence of foodborne infections were reached in 2007.
A report issued in June 2018 by NBC's Minneapolis station using research by both the CDC and the Minnesota Department of Health concluded that foodborne illness is on the rise in the U.S.
Organizations
The World Health Organization Department of Food Safety and Zoonoses (FOS) provides scientific advice for organizations and the public on issues concerning the safety of food. Its mission is to lower the burden of foodborne disease, thereby strengthening the health security and sustainable development of Member States. Foodborne and waterborne diarrhoeal diseases kill an estimated 2.2 million people annually, most of whom are children. WHO works closely with the Food and Agriculture Organization of the United Nations (FAO) to address food safety issues along the entire food production chain—from production to consumption—using new methods of risk analysis. These methods provide efficient, science-based tools to improve food safety, thereby benefiting both public health and economic development.
International Food Safety Authorities Network (INFOSAN)
The International Food Safety Authorities Network (INFOSAN) is a joint program of the WHO and FAO. INFOSAN has been connecting national authorities from around the globe since 2004, with the goal of preventing the international spread of contaminated food and foodborne disease and strengthening food safety systems globally. This is done by:
# Promoting the rapid exchange of information during food safety events;
# Sharing information on important food safety issues of global interest;
# Promoting partnership and collaboration between countries; and
# Helping countries strengthen their capacity to manage food safety risks.
Membership to INFOSAN is voluntary, but is restricted to representatives from national and regional government authorities and requires an official letter of designation. INFOSAN seeks to reflect the multidisciplinary nature of food safety and promote intersectoral collaboration by requesting the designation of Focal Points in each of the respective national authorities with a stake in food safety, and a single Emergency Contact Point in the national authority with the responsibility for coordinating national food safety emergencies; countries choosing to be members of INFOSAN are committed to sharing information between their respective food safety authorities and other INFOSAN members. The operational definition of a food safety authority includes those authorities involved in: food policy; risk assessment; food control and management; food inspection services; foodborne disease surveillance and response; laboratory services for monitoring and surveillance of foods and foodborne diseases; and food safety information, education and communication across the farm-to-table continuum.
Prioritisation of foodborne pathogens
The Food and Agriculture Organization of the United Nations and The World Health Organization have published a global ranking of foodborne parasites using a multicriteria ranking tool concluding that ''Taenia solium'' was the most relevant, followed by ''Echinococcus granulosus'', ''Echinococcus multilocularis'', and ''Toxoplasma gondii''. The same method was used regionally to rank the most important foodborne parasites in Europe ranking ''Echinococcus multilocularis'' of highest relevance, followed by ''Toxoplasma gondii'' and ''Trichinella spiralis''.
Regulatory steps
Food may be contaminated during all stages of food production and retailing. In order to prevent viral contamination, regulatory authorities in Europe have enacted several measures:
* European Commission Regulation (EC) No 2073/2005 of November 15, 2005
* European Committee for Standardization (CEN): Standard method for the detection of norovirus and hepatitis A virus in food products (shellfish, fruits and vegetables, surfaces and bottled water)
* CODEX Committee on Food Hygiene (CCFH): Guideline for the application of general principles of food hygiene for the control of viruses in food"Codex Committee on Food Hygiene (CCFH)"
European Commission, Retrieved April 7, 2015
See also
* ''American Public Health Association v. Butz
''American Public Health Association v. Butz'' (APHA v. Butz), 511 F.2d 331 (D.C. Cir. 1974) was a United States Court of Appeals for the District of Columbia Circuit case argued on January 22, 1974, and decided on December 19, 1974.
Case
The appe ...
''
* Food allergy
* Food microbiology
* Food quality
* Food safety
Food safety (or food hygiene) is used as a scientific method/discipline describing handling, preparation, and storage of food in ways that prevent food-borne illness. The occurrence of two or more cases of a similar illness resulting from t ...
* Food spoilage
* Food testing strips
Food testing strips are products that help determine whether or not food contains bacteria that can cause foodborne illness. These products can typically be used on food, water, and hard surfaces, and are often designed for quick and easy home and ...
* Gastroenteritis
Gastroenteritis, also known as infectious diarrhea and gastro, is an inflammation of the gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydra ...
* List of foodborne illness outbreaks by country
* List of food contamination incidents
* Mycotoxicology
Mycotoxicology is the branch of mycology that focuses on analyzing and studying the toxins produced by fungi, known as mycotoxins.Bennett, J. W. 1987. Mycotoxins, mycotoxicoses, mycotoxicology and mycopathology. Mycopathlogia 100:3-5. In the food ...
* Refrigerate after opening
The term refrigerate after opening is an instruction on commercial preserved food products to cool the container after it has been opened and the contents exposed to open air.
Moist foods are commonly preserved using canning and vacuum sealing ...
* STOP Foodborne Illness
Stop Foodborne Illness, or STOP (formerly known as Safe Tables Our Priority), is a non-profit public health organization in the United States dedicated to the prevention of illness and death from foodborne pathogens. It was founded following th ...
* United States Disease Control and Prevention
* Zoonotic pathogens
References
Further reading
Periodicals
International Journal of Food Microbiology
, Elsevier
Foodborne Pathogens and Disease
, Mary Ann Liebert, Inc.
Mary Ann Liebert, Inc. is a privately held independent publishing company founded by its president, Mary Ann Liebert, in 1980. The company publishes peer-reviewed academic journals, books, and trade magazines in the areas of biotechnology, biom ...
* '' Mycopathologia'', (electronic), (paper), Springer
Books
* (electronic).
*
*
*
External links
Foodborne diseases, emerging
WHO, Fact sheet N°124, revised January 2002
Foodborne illness information pages
, NSW Food Authority
Food safety and foodborne illness
WHO, Fact sheet N°237, revised January 2002
UK Health protection Agency
US PulseNet
Food poisoning
from NHS Direct Online
NHS Direct was the health advice and information service provided by the National Health Service (NHS), established in March 1998. The nurse-led telephone information service provided residents and visitors in England with healthcare advice 24 hou ...
Food Safety Network
hosted at the University of Guelph, Canada.
Food Standard Agency website
{{DEFAULTSORT:Foodborne Illness
Food safety
Health disasters