Foodborne Illnesses

World Scenario:

 2.1 million people died from diarrheal

diseases in 2000 in the world
 76 million cases of foodborne diseases
results in 325,000 hospitalizations and
5,000 deaths in the US in 1999

Cost of Foodborne Illness

U.S. - $6.9 billion/yr.

South Korea - $16-$28 million/yr.
Australia - $1.7 billion in 1999
Philippine Scenario:

 Food-borne illnesses - classified as

diarrheal disease
 Diarrheal disease - #1 cause of
morbidity (1,134.80 morbidity per
100 000 population)
9th of the top 10 causes of
mortality
79% of foodborne illnesses
cases in 1996 occurred while in
the workplace, parties, and
weddings or outside the home
Highly Susceptible Populations

Young
Old
Pregnant
Immuno-compromised
 Signs and symptoms

Fever
Upset stomach Diarrhea

Dehydration
Vomiting (sometimes severe)
Possible more severe conditions

Meningitis

Paralysis
 Don’t count on these to
test for food safety!

Sight

Smell Taste
Even IF tasting would tell …
Why risk getting sick?

A “tiny taste” may not

protect you … as few as
10 bacteria could cause
some foodborne illnesses!
Why gamble with your health?

It takes about ½ hour

to 6 weeks to become
ill from unsafe foods.

You may become sick later

even if you feel
OK after eating.
 Why risk other people’s health?

Is the food safe for

everyone at the table? Some people have
a greater risk for
foodborne illnesses.
A food you safely eat might
make others sick.
Cost of Foodborne Illness in the
Food Service Industry
 Ten Least Wanted
Foodborne Pathogens
• Campylobacter • Staphylococcus
jejuni aureus
• Clostridium • Shigella sp.
botulinum • Toxoplasma gondii
• E.coli O157:H7 • Vibrio vulnificus
• Listeria • Yersinia
monocytogenes enterocolitica
• Salmonella spp.
 Ten Least Wanted
Foodborne Pathogens
Causative Agent Source of Illness Symptoms Prevention
Methods

Campylobacter Raw poultry, meat, Diarrhea, fever, Cook food

jejuni and unpasteurized abdominal pain, thoroughly, avoid
milk nausea, headache, cross-
muscle pain, & contamination,
sometimes bloody avoid
stool unpasteurized milk
Clostridium Soil & water Double vision, Practice time-
botulinum inability to swallow, temperature
speech difficulty, & control for large
progressive bulky foods, cool
paralysis of leftovers rapidly
respiratory system
 Ten Least Wanted
Foodborne Pathogens
Causative Agent Source of Symptoms Prevention Methods
Illness

E. coli O157:H7 Infected cattle Severe abdominal Cook ground beef

pain, bloody thoroughly, avoid
diarrhea, nausea, cross-contamination,
vomiting practice good personal
hygiene
Listeria Animal Nausea, vomiting, Avoid raw milk, cook
monocytogenes intestines, soil, headache, fever, foods to proper
milk, leafy backache, temperatures, avoid
vegetables, respiratory cross-contamination,
poultry, meat, distress, meningitis clean and disinfect
seafood, &
prepared,
chilled, ready-
to-eat foods
 Ten Least Wanted
Foodborne Pathogens
Causative Agent Source of Symptoms Prevention Methods
Illness

Salmonella spp. Poultry, eggs, Nausea, fever, Avoid cross-

meats, fish, headache, contamination of
milk, & products abdominal cramps, foods, ensure
made with them diarrhea, & thorough cooking of
sometimes foods, prompt &
vomiting proper refrigeration,
practice good personal
hygiene
Staphylococcus Human skin, Diarrhea, vomiting, Avoid contamination
aureus nose, throat, nausea, abdominal from hands, exclude
infected sores, & cramps, & physical food handlers with
in animals exhaustion skin infections from
preparation, ensure
proper refrigeration,
rapid cooling of
prepared food
 Ten Least Wanted
Foodborne Pathogens
Causative Agent Source of Symptoms Prevention Methods
Illness

Shigella sp. Fecally Abdominal pain, Avoid cross-

contaminated cramps, diarrhea, contamination of
food or water fever, vomiting, & foods, avoid fecal
blood, pus, or contamination by food
mucus in stool handlers, practice
good personal
hygiene, use sanitary
food & water sources,
ensure control of flies,
cool food rapidly
Toxoplasma gondii Animal feces, Enlarged lymph Avoid raw or
mammals, birds nodes in head & undercooked meat,
neck, severe thoroughly cook
headache, severe meats, practice good
muscle pain, rash personal hygiene
 Ten Least Wanted
Foodborne Pathogens
Causative Agent Source of Symptoms Prevention Methods
Illness

Vibrio vulnificus Oysters & other Diarrhea, Avoid raw or

shellfish abdominal cramps, undercooked seafood,
nausea, vomiting, avoid cross-
headache, chills, contamination
fever, blistering
skin lesions
Yersinia Domestic pigs, Fever, severe Avoid cross-
enterocolitica soil, water, wild abdominal pain, contamination,
animals, rodents possible diarrhea, thoroughly cook
headache, sore foods, sanitize food
throat, vomiting contact surface,
proper storage
procedures, use
sanitary water
supplies
 Factors Contributing to Outbreaks of Foodborne Illness in
Foodservice Establishments

Improper Cooling
Advance Preparation
0.2 Infected Person
0.5 0.1
1 0.1 Inadequate Reheating
2.5 2 2
3.5
2.5 Improper Hot Storage
30
5 Contaminated Ingredient
Unsafe Source
9
Use of Leftovers
Cross-Contamination
Inadequate Cooking
Toxic Substances
11
17 Intentional Additives
13
Improper Thawing
Contaminated Water
Mistaken for Food
Improper Dishwashing
Factors Contributing to Foodborne Illness in
the Philippines (by rank, by % outbreak,
1988-1996)
• Improper food storage temperature
• Poor hygienic practices
• Inadequate cooking
• Use of dirty utensils and equipment
• Eating of expired and sewage-
contaminated food
 Trends in Food-borne Disease
Outbreaks (FBDO) in the
Philippines (1995 – 2004)

• Meat-based dishes and products –

more significant causes of FBDO
• Spaghetti meat sauce – main
causative food vehicle

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

 Food disease outbreaks in the Philippines
(n=60, 1995-2004) classified by
incriminated food types
Food Type Percentage
(%)
Meat-based dishes and processed meat 31.67
products

Fish and other seafood dishes 20.00

Bakery and confectionery products 16.67

Toxin-containing or un-edible materials 13.33

Other dishes 10.00

Beverages 8.33

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

 Outbreak Location for Philippine Foodborne
Disease
(N=60, 1995-2004)

Percentage (%)
occurrence morbidity mortality
Home 43.33 18.17 96.00
Workplaces 20.00 38.61 4.00

Schools 15.00 24.60 0.00

Restaurant 11.67 7.67 0.00
Unknown 10.00 10.96 0.00

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

 Ranking of causative agents of foodborne poisoning in the
Philippines based on recorded morbidity cases (n=3313 out
of 60 outbreaks, 1995-2004)
Type of Food Poisoning Percentage
Microbiological Chemical/ toxin %
Salmonella spp. 29.73
Staphylococcal enterotoxin 23.15
14.49*
V. parahemolyticus 10.14
paralytic shellfish toxin 4.35
V. cholerae 4.35
Histamine 3.74
Aeromonas spp. 2.20
E. coli 2.11
Psylocibin/ Psilocin 1.42
*Unclassified
Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.
Ranking of causative agents of foodborne poisoning in the
Philippines based on recorded morbidity cases (n=3313 out
of 60 outbreaks, 1995-2004) continued…
Type of Food Poisoning Percentage
Microbiological Chemical/ toxin %
Cigua toxin 1.15
Jatropha curcas toxin 0.75
Nitrite 0.75
Amatoxin 0.51
Tetradotoxin 0.63
Chlorphyllum molybdites toxin 0.21
Arsenic 0.15
Methanol 0.15
Dioscorine 0.12
B. cereus toxin 0.09
Kerosene 0.03
Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.
 Ranking of causative agents of foodborne poisoning in the
Philippines based on recorded mortality cases (n=25 cases out
of 60 outbreaks, 1995-2004)

Causative Agent Percentage (%)

Paralytic shellfish toxin 34.62
Tetradotoxin 19.23
Methanol 19.23
Dioscorine 7.69
Arsenic 7.69
Unclassified 7.69
Nitrite 3.85

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

 2005 Food-borne disease outbreaks

Outbreak Carrier Causal agent Morbid Mortali

area ities ties
Mabini, Bohol Cassava Carbamate 76 27
Concepcion, Spaghetti Staphylococcus 89 0
Tarlac
Manaoag, Spaghetti - 85 0
Pangasinan
Danao, Cebu Lechon - 27 0
San Jose, Bantoli - 15 0
Camarines
Sur
Isla Verde, Steak - 7 0
Batangas
Pasay City Adobong - 7 0
kangkong
Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.
 Formula of
Foodborne Illness

http://www.colostate.edu/orgs/safefood/safetyworks/handbook.pdf
Generally, foodborne illnesses
are due to…
• Time-temperature abuse
• Poor personal hygiene
• Cross-contamination
 Time-Temperature Abuse
• Situation at which food has been
allowed to remain for too long at
temperatures favorable for growth of
microorganisms
• Failing to hold or store foods at required
temperatures
• Failing to cook or reheat food to
temperatures that kill microorganisms
• Failing to cool foods properly
• Preparing food a day or more ahead
 Cross-Contamination
• Occurs when
microorganisms
are transferred
from one surface
or food to another