FOOD BORNE DISEASES

Dr. Radha Rani

Assistant Professor
Department of Biotechnology
Motilal Nehru National Institute of Technology Allahabad
Food borne diseases are acute illnesses
associated with the recent consumption of food
• The food involved is usually contaminated
with a disease pathogen or toxicant
• Such food contains enough pathogens or
toxicant necessary to make a person sick
Classification of food borne diseases
Food borne diseases are classified into:
1. Food borne infections
2. Food borne intoxications
Food borne infections
• Food borne infections are caused by the entrance of
pathogenic microorganisms contaminating food into
the body, and the reaction of the body tissues to their
presence.
• These can either be fungal, bacterial, viral or parasitic
• Food borne infections tend to have long incubation
periods and are usually characterized by fever
• Example: Salmonellosis, typhoid fever, shigellosis,
Yersiniosis Escherichia coli infection
Campylobacteriosis, Vibrio parahemolyticus and
Listeriosis , Mycotic food poisoning
 Food borne intoxication
• It refers to the consumption of toxic chemicals
liberated or produced by bacterial growth
in food.
• These respective toxins results in variety of illness
of the consumers.
• Can be bacterial, fungal, plant and animal poisons
• Staphylococcus aureus intoxication, Bacillus
cereus food borne intoxication, Clostridium
perfringens and Clostridium botulinum food
borne intoxication
Salmonellosis
• The salmonellae constitute a group of organisms with
over 2000 different serotypes
• These organisms are capable of causing disease in
animals and man when taken into the body in sufficient
numbers
• Many salmonella species have a wide host range.. S.
typhi, Salmonella paratyphi, Salmonella typhimurium,
Salmonella enteritidis
• A heavy dose up to 10,000 -1,000,000 organisms per
gram of food is required to cause infection
• Salmonellae grow well on food and can exist for a
considerable period in faeces.
• Salmonellae are killed by temperatures attained in
commercial pasteurization
Factors associated with Salmonella food
poisoning outbreaks
• Consumption of inadequately cooked or
thawed meat or poultry
• Cross-contamination of food from infected
food handlers
• Presence of flies, cockroaches, rats, in the food
environment that act as vectors of the disease
Transmission
• Salmonellae reach food in many different ways
a) Directly from slaughter animals to food
b) From human excreta, and transferred to food
through hands, utensils, equipments, flies
etc.
• Food poisoning is more likely to occur if the
total number of microorganisms present is
high.
Clinical symptoms
Abdominal pain, headache, diarrhea, fever, vomiting,,
prostration and malaise.
• In severe cases there is septicaemia with leucopenia,
endocarditis, pericarditis.
• Severe cases are encountered in babies, young children
, the sick and in elderly persons.
The mortality is upto 13 %.
Control measures
• Efficient refrigeration and hygienic handling of food.
• Consumption of properly cooked meat,
• Complete thawing of frozen meats and adequate
cooking.
• Heat processing of meat, milk , fish and poultry to
destroy salmonella organisms in food
Typhoid and Paratyphoid fever (Enteric fevers)
• Enteric fevers include typhoid and paratyphoid fevers
caused by Salmonella typhi and Salmonella paratyphi A, B
and C respectively.
• The serotypes are similar to other salmonella bacteria, but
unlike them, they are essentially parasites of man.
• S. typhi possesses usual O (surface LPS) and H (flagellar
protein) antigens found in other serotypes.
Disease symptoms
• The incubation period is usually 2 weeks, but might vary
between 3 and 28 days for typhoid fever and between 1
and 15 days for the paratyphoid fevers.
• The enteric fevers are generalized septicaemic infections
with a frequent, if not constant bacteraemia during the first
two weeks of the disease.
• The abdominal symptoms are severe, while fever and illness
may continue for 4-6 weeks.
Transmission
• The typhoid and paratyphoid bacilli are essentially
human parasites and are acquired mostly from human
sources, namely, patients and carriers.
• The bacteria can be transmitted by the contamination of
water, milk or food by flies.
• Only a few organisms are needed to cause disease.
Control measures
• Hygienic control of food and water supplies
• Detection and treatment of chronic carriers
• Vaccination using TAB-vaccine.
The vaccine contains a mixed culture of S. typhi, and S.
paratyphi. The vaccine protects for 5-7 yrs.
Campylobacteriosis
 Campylobacter are a group of tiny strictly microaerophilic
curved or spiral gram negative rods
 Campylobacter jejuni and Campylobacter coli cause food
poisoning and are associated with acute enterocolitis in
man.
 Campylobacter jejuni occur in large numbers in cattle feces,
and poultry as normal flora.
 Campylobacter coli are commonly associated with human
diarrhoea, and enteritis in pigs mostly in association with
Treponema hyodysenteriae.
Disease in man
• Campylobacter jejuni and C. coli cause illness characterized
by diarrhoea, abdominal pain, fever, nausea, vomiting, and
abdominal complaints.
• The jejunum, ileum and colon are primarily affected
resulting in acute inflammation and occasionally, abscess
formation.
Clinical signs
• Incubation period ranges between 2-11 days
with an average of 3-5 days.
• It is preceded by fever, followed by foul
smelling and watery diarrhea, which runs for
3-4 days.
• The diarrhea may sometimes contain blood
and mucus in feces.
• Abdominal pain is associated with backache,
• The condition is self-limiting but may last for
up to 10 days.
Escherichia coli food borne infection
Escherichia coli are potential food poisoning
pathogens which are widely distributed in low
numbers in food environments
E. coli strains involved in food borne infection
fall into the following groups:
1. Enteropathogenic E. coli (EPEC)
2. Enterotoxigenic E. Coli (ETEC)
3. Enteroinvasive E. coli (EIEC)
4. Enterohemorrhagic E. coli (EHEC)
• Each group is composed of unique O:H serotypes
• The serotypes are characterized by using O somatic and
H-flagella antigens.
Enteroinvasive E. coli
• EIEC strains cause illness that is characterized by watery
diarrhea in most patients.
• In addition, there is fever, nausea, and abdominal
cramps.
• Bloody diarrhea may occur in fewer than 10 % of
patients.
• The presence of mucus and polymorphonuclear
leucocytes in stool is typical of these strains.
• Illness is usually self-limiting, lasting for 2 to 3 days.
• Enterohemorrhagic E. Coli
 EHEC infection is caused by Escherichia coli
serotype O157:H7
 It causes hemorrhagic colitis in humans that is
characterized by diarrhea, abdominal pain which
may be severe and vomiting.
 Few patients develop fever. Illness lasts for 4 to 8
days, although it may extend to 13 days for
severe cases.
 Patients with complications have bloody diarrhea,
acute ulcerative or ischemic colitis and sub-
mucosal edema with severe colonic
inflammation.
Shigellosis (Bacillary dysentery)
• Shigellosis is caused by members of the genus
Shigella.
• The species involved include Shigella dysenteriae,
Shigella flexneri, Shigella boydii and Shigella
sonei.
• All strains of shigella posses potent exotoxins
which are carbohydrate-lipid protein complexes.
• The infective dose is smaller than that of
salmonellae, except S. typhi.
• The illness begins 1 to 4 days after ingestion of
bacteria and may last 4 to 7 days.
• .
• Symptoms include watery or bloody diarrhea, fever,
stomach cramps, nausea or vomiting, dehydration and
prostration in severe cases and convulsions in young
children.
• The diarrhea which starts as a thin watery discharge
quickly looses its fecal character to be composed of
nothing but pus, mucus threads and blood.
• At this stage, there are agonizing pains and constant
tenesmus.
• Death from bacillary dysentery is uncommon when
efficient treatment is provided.
• However, S. dysenteriae infections have been reported
to have a case fatality rate of 20 % and the mortality
rate is higher in children than adults
Cholera
• Cholera is caused by Vibrio cholera bacterium.
• Cholera vibrios are ingested in drink or food. In natural
infection, the dosage is usually very small.
• The organism multiply in the small intestine to produce
a very potent enterotoxin, which stimulates a
persistent out pouring of isotonic fluid by the gut
mucosal cells.
• Man is the only natural host of the cholera vibrios
• Spread of infection is from person-to-person, through
contaminated water or foods.
• Shrimps and vegetables are the most frequent carriers.
• Cholera is an infection of crowded poor class
communities and it tends to persist in such areas.
• characterized by the sudden onset of effortless vomiting
and profuse watery diarrhea
• Vomiting is seen frequently, but very rapid dehydration and
hypovolemic shock.
• The frequent watery stools may be accompanied with small
parts of the mucosa being liberated from the intestines.
• Death may occur in 12 to 24 hrs due to rapid dehydration.
• Patients may produce up to 20-30 stools per day, losing
many litres of water and electrolytes
• Patients therefore exhibits extreme dehydration, urine is
suppressed, the skin becomes wrinkled, the eyeballs are
sunken and the voice becomes weak and husky.
• Blood pressure falls, the heart sounds become barely
audible and the pulse become rapid and weak
• Vibrio parahemolyticus is a pathogenic
bacterium, whose natural habitat is the sea.
• Human infections occur solely from sea foods
such as oysters, shrimps, crabs, lobsters, clams
and related shellfish
• Cross-contamination may lead to other foods
becoming vehicles
• Causes gastroenteritis and extra intestinal
infections in man.
• Symptoms include: diarrhea (95 %), cramps (92
%), weakness (90 %), nausea (72 %), chills (55 %),
headache (48 %) and vomiting (12 %).
Listeria monocytogenes infection (Listeriosis)
• Listeria monocytogenes is a gram positive bacterium that is
pathogenic to both animals and human beings.
• Widespread in nature and is a transient constituent of the
intestinal flora excreted by 1-10% of healthy humans.
• It is extremely hardy and can survive for many years in the
cold in naturally infected sources.
• infection occurs after consumption of raw vegetables, raw
milk, meat and meat products, poultry, sea foods, and meat
• Clinical symptoms : abortion in pregnant women,
meningitis in newborn infants and immuno-compromised
adults.
• Pregnant women, infants and elderly people are
particularly at risk of infection with Listeria
monocytogenes.
Yersinia enterocolitica infection
• Has been isolated from beef, lamb, pork, sea foods,
vegetables milk and cakes, vacuum-packed meat.
• Swine is the major source of strains pathogenic to man.
• Yersinia gastroenteritis symptoms : abdominal pain,
diarrhea, fever, vomiting, headache and pharngitis
• The organism may be shed in stools for up to 40 days
following illness.
• A variety of systemic involvement may occur as a
consequence of the gastroenteritis syndrome.
• They include pseudo appendicitis, peritonitis, terminal
ileitis, reactive arthritis, colon and neck abscess
• The organism can be recovered from urine, blood,
cerebrospinal fluid and eye discharges of infected
individuals.
VIRAL FOODBORNE INFECTIONS

• Viruses are common pathogens transmitted through food.

• Hepatitis A and Norwalk-like virus (Norovirus) are the most
important viral food borne pathogens.
• These viruses are highly infectious and may lead to
widespread outbreaks.
Infectious hepatitis A
• Incubation period is long, being an average of 30 days
(range 15-50 days).
• Systemic infection characterized by gastrointestinal
manifestations and liver injury, fever, malaise anorexia,
nausea, abdominal discomfort, bile in urine and jaundice.
• The duration of the disease could be from a few weeks to
several months.
NOROVIRUS
Norwalk-like virus (Norovirus) food borne infection
• Novovirus infection is relatively mild with an incubation
period of 3 days.
• Clinical manifestations include vomiting and diarrhea, and
convulsions.
• Asymptomatic infection are common and may contribute to
the spread of the infection.
• Infections have resulted from consumption of raw oyesters.
RICKETTSIAL FOODBORNE INFECTION
• Rickesttsia: nonmotile, Gram-negative, nonspore-
forming, highly pleomorphic bacteria
• Q-Fever: caused by Coxiella burnetti
• Symptoms include a sudden onset of fever, dry cough
and chest pain due to a pneumonitis.
• Hepatic disorders which include slight jaundice occur in
severe cases.
• Q-fever is mostly an occupational disease among
people who handle livestock and raw animal products
(e.g. farm and slaughterhouse workers etc).
• Infection occurs through consumption of raw milk,
contaminated butter and cheese.
Food and water borne protozoans: Amoeba,
Cryptosporidium, Giardia, Cyclospora, Toxoplasma
Amebiasis caused by Entamoeba histolytica, cuases
dydentry and gastroenteritis.
Can affect anyone, although it is more common in people
who live in tropical areas with poor sanitary conditions.
Nematodes (roundworms) are non-segmented
worms (helminths) with elongate cylindrical
bodies.
Intestinal nematodes: Ascaris lumbricoides;
Trichuris trichiura (whipworm); Ancylostoma
duodenale and Necator americanus (the two
human hookworms); Enterobius vermicularis
(pinworm); and Strongyloides stercoralis.