FOOD BORNE DISEASES

Dr Vandana Sharma
PhD, Science
 Foodborne diseases
 Foodborne diseases encompass a wide spectrum of illnesses and are a growing
public health problem worldwide. They are the result of ingestion of foodstuffs
contaminated with microorganisms or chemicals. The contamination of food may
occur at any stage in the process from food production to consumption (“farm to
fork”) and can result from environmental contamination, including pollution of
water, soil or air.

 The most common clinical presentation of foodborne disease takes the form of
gastrointestinal symptoms; however, such diseases can also have neurological,
gynaecological, immunological and other symptoms. Multiorgan failure and even
cancer may result from the ingestion of contaminated foodstuffs, thus
representing a considerable burden of disability as well as mortality.
 Common Foodborne Disease
Causative Agents

Bacteria Viruses Parasites Chemicals/other Heavy metals

✓Bacillus cereus ✓Norovirus ✓ Cryptosporidium ✓ Pesticides
✓Campylobacter ✓Astrovirus ✓ Cyclospora cayetanensis ✓ Fungal toxins
✓Clostridium botulinum ✓Hepatitis A virus ✓ Entamoeba histolytica ✓ Fish toxins
✓Clostridium perfringens ✓ Giardia intestinalis Trichinella
✓Escherichia coli
• Shiga toxin-producing E. coli
• Enterotoxin producing E. coli
• Enteropathogenic E. coli

✓ Salmonella, non-typhoid
✓ Salmonella Typhi
✓ Shigella
✓ Staphylococcus aureus
✓ Vibrio
✓ Yersinia enterocolitica
 Foodborne illness

Foodborne illness occurs when a pathogen is ingested with food and establishes itself (and
usually multiplies) in the human host, or when a toxigenic pathogens establishes itself in a
food product and produces a toxin, which is then ingested by the human host.

Foodborne illness is generally classified into:

(a) foodborne infection
(b)foodborne intoxication.
 What is a foodborne infection?

A foodborne infection is an inflammation of the stomach and bowels. The

infection can happen when you eat or drink something that is contaminated by a
bacteria, virus or parasite.
Often the inflammation leads to
✓ diarrhoea,
✓ nausea,
✓ vomiting,
✓ abdominal pain,
✓ abdominal cramps and sometimes fever.
A foodborne infection can last between one and three days.
 Foodborne intoxication

Foodborne intoxication is caused

by consumption of food
containing toxins. Toxins cause
foodborne diseases such as
gastrointestinal and systemic
disorders.
 Staphylococcus aureus: Foodborne Intoxication

Description
Staphylococcal
foodborne intoxication
Causative Agent
is a gastrointestinal
Staphylococcus aureus is a
illness, caused by
common bacterium found
consumption of food
colonising the skin and nasal
contaminated with
passageways. S. aureus has the
toxins produced by
capacity to produce a range of
Staphylococcus
enterotoxins (toxins that act
aureus. Symptoms
within the intestine) that damage
Symptoms occur
the mucosal endothelium making
suddenly, sometimes in as
the mucosae more permeable to
little as 30 minutes after
ions and water leading to vomiting
eating contaminated food.
and diarrhoea. Enterotoxins are
They include severe
stable at 100°C. Staphylococci
nausea, cramps, vomiting
replicate in food.
and often diarrhea. In
most cases the illness is
short-lived usually lasting
not longer than one to two
days.
Causes
Staphylococcal food intoxication is caused by eating contaminated food. The most common way
for food to become contaminated with the bacteria is through contact with food workers who carry
the bacteria or through contaminated milk or cheeses. The staphylococcal bacteria are resistant to
heat and cannot be destroyed by cooking. Common foods that can become contaminated are pastries,
custards, salad dressings, sandwiches, sliced meat and meat products.

Treatment
The toxin is not affected by antibiotics, thus antibiotics are not useful. Plenty of rest, plenty of
fluids and medications to calm the stomach are recommended. Those most at risk for severe illness
such as young children, the elderly and individuals with a weakened immune system may require
intravenous therapy and care in the hospital.

Prevention
Staphylococcal food intoxication can be prevented by practicing safe handling and proper storage
of food, frequent hand washing with soap and water, keeping kitchens and food serving areas clean and
sanitized, and educating food handlers in strict food hygiene.
 Clostridium botulinum

Clostridium botulinum are anaerobic, Gram-positive,

spore-forming bacilli that are found in soils and
aquatic sediments. Strains of C. botulinum are
classified into seven types, designated A to G,
according to the antigenic properties of
the botulinum toxin they produce.
Human botulism is caused by types A, B, E and,
rarely, type F. Some strains of Clostridium
baratii and Clostridium butyricum can also produce
botulinum neurotoxin and have been implicated in
human disease.

The spores of C. botulinum are highly resistant. Under appropriate conditions, they
germinate to release vegetative organisms that produce neurotoxin. Following absorption
and hematogenous dissemination, botulinum toxin exerts its effects at the presynaptic
terminals of cholinergic nerve junctions by blocking neurotransmitter release.
 Botulism

Botulism is a life-threatening disease caused by the ingestion of a potent neurotoxin produced during
growth of the C. botulinum bacteria. This neurotoxin is among the most toxic substances known; even
microscopic amounts can cause illness or death. In the past, botulism was linked primarily to home-
canned foods. In recent decades, however, botulism illnesses have been linked to foods such as
unrefrigerated homemade salsa, baked potatoes sealed in aluminum foil, honey (the primary cause of
botulism in infants), garlic in oil, and traditionally prepared salted or fermented fish.
 The Disease
Botulism is a paralyzing disease affecting the
body's nervous system that is caused by the
ingestion of one of the potent neurotoxins
produced by C. botulinum bacterium. This
neurotoxin is among the most toxic substances
known; even microscopic amounts can cause
illness.
 How is the Toxin Produced in Food?

C. botulinum spores are often found on the Symptoms

surfaces of fruits and vegetables and in
seafood. The organism grows best under Symptoms of botulism usually appear within 12
low-oxygen conditions and produces spores to 36 hours after eating food containing the
and toxins. The toxin is most commonly neurotoxin, although there have been
formed when food is improperly processed documented cases that ranged from 4 hours to
(canned) at home. C. botulinum cannot grow 8 days. The earlier the symptoms appear, the
below a pH of 4.6, so acidic foods, such as more serious the disease. Treatment requires
most fruits, tomatoes, and pickles, can be quick medical attention and an antitoxin.
safely processed in a water bath canner.
However, foods with a higher pH (most
vegetables and meats) must be processed
under pressure. Therefore, a pressure
cooker should be used. The pressure
cooker will reach high enough
temperatures to destroy the C.
botulinum spores.
 How Does the Illness Occur?

Once in the body, the toxin binds to nerve endings that join muscles. This prevents the nerves
from signaling the muscles to contract. The first symptoms of botulism are nausea, vomiting,
weakness, and vertigo (dizziness). These are followed by neurological symptoms: visual impairments
(blurred or double vision), loss of normal throat and mouth functions (difficulty speaking and
swallowing; dry mouth, throat, and tongue; and sore throat), general fatigue, lack of muscle
coordination, and difficulty in breathing. Gastrointestinal symptoms may include abdominal pain,
diarrhea, or constipation. Death is usually caused by respiratory failure and airway obstructions.
When the diaphragm and chest muscles become fully involved, breathing is affected and results in
death from asphyxia.

If botulism is caught in the early stages, the injection of an antitoxin can lessen the severity of
the disease by neutralizing any toxin that has not yet bound to nerve endings. However, due to the
risk of serious side effects, the antitoxin cannot always be used. A human-derived antitoxin is
used to treat cases of infant botulism and is available from the California Department of Public
Health.
 Infant botulism

Infant botulism may affect infants

under 12 months of age, but most
commonly those under 2 months of age.
It occurs when infants eat food, such as
honey, that contains spores of C.
botulinum that germinate, colonize, and
produce neurotoxin in the infant's
intestinal tract.
For this reason, the U.S. Food and
Drug Administration, the Center for
Disease Control and Prevention, and the
American Academy of Pediatrics
recommend that honey not be given to
children under 1 year of age. Also, fruits
and vegetables should be washed before
being fed to infants.
 What is the Best Way to Prevent Botulism?

The control of foodborne botulism is based almost entirely on thermal destruction (heating) of
the spores or inhibiting spore germination into bacteria and allowing cells to grow and produce
toxins in foods. To prevent foodborne botulism:
• Use approved heat processes for commercially and home-canned foods (i.e., pressure-can low-
acid foods such as corn or green beans, meat, or poultry).
• Discard all swollen, gassy, or spoiled canned foods. Double bag the cans or jars with plastic bags
that are tightly closed. Then place the bags in a trash receptacle for non-recyclable trash
outside the home. Keep it out of the reach of humans and pets.
• Do not taste or eat foods from containers that are leaking, have bulges or are swollen, look
damaged or cracked, or seem abnormal in appearance. Do not use products that spurt liquid or
foam when the container is opened.
• Boil home-processed, low-acid canned foods for 10 minutes prior to serving. For higher
altitudes, add 1 minute for each 1,000 feet of elevation.
 What is the Best Way to Prevent Botulism?

• Refrigerate all leftovers and cooked foods within 2 hours after cooking (1 hour if
the temperature is above 90 °F).
• One of the most common causes of foodborne botulism is improperly home-canned
food, especially low-acid foods such as vegetables and meats. Only a pressure
cooker/canner allows water to reach 240 to 250 °F, a temperature that can kill the
spores.
 Mycotoxins

Mycotoxins are secondary metabolites synthesized by a variety of fungal species such as

Aspergillus, Penicillium, Fusarium, and Alternaria. These secondary metabolites are toxic and
have a significant impact if they enter the production and food chain.

fungal metabolites which when ingested, inhaled, or

absorbed through the skin can cause disease or death
in humans and domestic animals, including birds.

Some mycotoxins cause primarily acute and highly

reversible effects, others cause irreversible organ
damage, and still others cause both acute and chronic
effects, depending upon exposure levels, time course,
and other circumstances.

Most mycotoxins are chemically and thermally stable

during food processing, including cooking, boiling,
baking, frying, roasting, and pasteurization. Mycotoxins
can also come to the human plate via animal products
such as meat, eggs, milk as the result of the animal
eating contaminated feed
 FOOD SAFETY AND REGULATION

Mycotoxins can enter the food chain in the field,

during storage, or at later points. Mycotoxin problems
are exacerbated whenever shipping, handling, and
storage practices are conducive to mould growth. The
end result is that mycotoxins are commonly found in
foods.

Moulds and mycotoxin contamination in animal food and

feed can be easily attained by keeping moisture under
control, maintenance of temperature unfavourable to
their growth and cleaning of equipment’s.
For detail study on mycotoxin, reference

Mycotoxins: The Hidden Danger in Foods

By Aycan Cinar and Elif Onbaşı
Submitted: February 27th 2019Reviewed: August 2nd
2019Published: September 20th 2019
DOI: 10.5772/intechopen.89001