Food-borne illness

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, microbes, like bacteria (if applicable), can pass through the stomach into the intestine 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, for example.

Causes

Foodborne illness usually arises from improper handling, preparation, or food storage. 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. 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 pesticides, 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'' 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'' 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''
* ''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 (exotoxins 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'' 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, 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 restaurants). 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 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 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 (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, cirrhosis, and carcinoma.
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

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