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1.INTRODUCTION

Food borne diseases-(intoxications and
   infections) covers illnesses acquired
   through consumption of contaminated
   food-i.e food poisoning
Food borne disease outbreaks-occurrence of 2
   or more cases of similar illness resulting
   from ingestion of common food OR when
   observed number of paticular disease
   exceeds expected number
Most cases-sporadic but need investigations
   for control
1.INTRODUCTION –BURDEN

Global burden-high morbidity and mortality
Infectious diarrhoea-3 to 5 billion cases
  and 1.8 million deaths annually
CDC-76 million cases of food borne
 diseases in US annually with appx.5000
 deaths
FOOD BORNE INFECTIONS VS
            INTOXICATION
Infections-                        Intoxications-toxins
   Bacterial/Viral/parasite           (natural/preformed
                                      bacterial/chemical)
Invade and or multiply in lining
   of intestine                    No invasion or multiplication
Incubation period-hours to         Incubation period-minutes to
   days                               hours
s/s-diarrhoea,nausea,vomitting,    s/s-
                                      vomitting,nausea,diarrhea,di
abdominal cramps,fever
                                      plopia,weaakness,resp.failur
Transmission-spreads from             e,numbness,sensory/motor
   person to person                   dysfunction
Factors-inadequate                 Not communicable
  cooking,cross
                                   Factors-inadequate
  contamination,poor personal
                                     cooking,improper handling
  hygiene,bare hand contact
                                     temperatures
SOME IMPORTANT FOOD-BORNE
PATHOGENS,TOXINS AND
CHEMICALS
1.Bacteria-Bacillus
   cereus,brucella,campylobacter,clostridium
   sp,e.coli,Salmonella sp,listeria,staph aureus,,vibrio
   cholera and parahemolyticus
2.viruses-hepatitis a and e,rotavirus,norvovirus,
3.protozoa-
   cryptosporidium,cyclospora,entamoeba,giardia,t
   gondii
4.trematodes,cestodes and nematodes
FOOD BORNE PATHOGENS-
   TOXINS AND CHEMICALS
Toxins-marine biotoxins,tetrodotoxin(pufferfish),pyrrolizidine alka,mushroom
   toxins,shellfish toxins,mycotoxins,plant toxicants
Chemicals-pesticides(opp,sb),radionuclides,nitrites(food preservatives),toxic metals-
   cd,cu,hg,pb,sn,fluoride,MSG
PATHOGENESIS AND TRANSMISSION
Infectious agent or contaminant
Inoculum/size of infective dose-can be as small
  as 10-100 bacterial cysts for
  shigella,EHEC,giardia,E.histolytica or 10^ 5-
  10^ 8 for vibrio cholera,variable for
  salmonella

Animals or humans harbouring infectionshed
 in fecescontaminate
 water,fruits,vegetablesinadequate
 cooking/improper storageinfection
Warm temperature(10-50 degree cent.)-
 multiplication of pathogens
SOME COMMON BACTERIAL FOOD
POISONS
Incubation   cause       symptoms    Common
period                               foods
1-6 hours    Staph      Nausea,vo Milk n milk
             aureus(ent mitting,diarr products,ha
             erotoxin)  hea           m,poultry,s
                                      alads,custa
                                      rds
             Bacillus   Nausea,vo Fried rice
             cereus(ent mitting,(em
             erotoxin)  etic form)
SOME COMMON BACTERIAL FOOD POISONS

Incubation Cause           symptoms          Common
period                                       foods
8-16      Clostridium      Abd.cramps,       Meat,
hours     perfringes       diarrhea          poultry,
          (spores)         Nausea and        legumes.
                           vomitting-rare    gravies
          Bacillus         Diarrhea,abd.
          cereus(diarrhe   pain,nausea,
          al form-         No
          preformed n      vomitting/fever
          stable toxins)
SOME COMMON BACTERIAL FOOD
POISONS
Incubation cause        symptoms    Common
period                              foods
>16 hours Vibrio        Rice watery Water and
           cholera      stools      ice
                                    creams,sea
                                    food
          Salmonella    Inflammato Meat,milk n
          spp           ry diarrhea milk
                                    products,po
                                    ultry
          Shigella sp   dysentry    Potato/raw
                                    eggs-salad
EARLY DIAGNOSIS AND
INVESTIGATIONS
1.Initial assessment of cases-Detailed clinical
  history including time of onset,duration of
  illness,symptoms,h/o travel,recent
  meals,cooking and refrigeration,details of
  others with similar complaints


2.Detailed clinical examination-vitals and
  degree of dehydration,systemic signs
LAB DIAGNOSIS
Main objectives-
a)To confirm clinical diagnosis by isolation of
  causative agent from proper samples,eg-
  stool,vomitus/gastric aspirate,food
  specimens
b)Ensure proper identification of disease
c)Determine causative agent if present in food
  sources with relevant epidemiological
  markers-eg Biotyping,serotyping,pcr,phage
  typing etc
THE SOLUTION!!
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Five keys

  • 1.
  • 2.
  • 3.
  • 4. 1.INTRODUCTION Food borne diseases-(intoxications and infections) covers illnesses acquired through consumption of contaminated food-i.e food poisoning Food borne disease outbreaks-occurrence of 2 or more cases of similar illness resulting from ingestion of common food OR when observed number of paticular disease exceeds expected number Most cases-sporadic but need investigations for control
  • 5. 1.INTRODUCTION –BURDEN Global burden-high morbidity and mortality Infectious diarrhoea-3 to 5 billion cases and 1.8 million deaths annually CDC-76 million cases of food borne diseases in US annually with appx.5000 deaths
  • 6. FOOD BORNE INFECTIONS VS INTOXICATION Infections- Intoxications-toxins Bacterial/Viral/parasite (natural/preformed bacterial/chemical) Invade and or multiply in lining of intestine No invasion or multiplication Incubation period-hours to Incubation period-minutes to days hours s/s-diarrhoea,nausea,vomitting, s/s- vomitting,nausea,diarrhea,di abdominal cramps,fever plopia,weaakness,resp.failur Transmission-spreads from e,numbness,sensory/motor person to person dysfunction Factors-inadequate Not communicable cooking,cross Factors-inadequate contamination,poor personal cooking,improper handling hygiene,bare hand contact temperatures
  • 7. SOME IMPORTANT FOOD-BORNE PATHOGENS,TOXINS AND CHEMICALS 1.Bacteria-Bacillus cereus,brucella,campylobacter,clostridium sp,e.coli,Salmonella sp,listeria,staph aureus,,vibrio cholera and parahemolyticus 2.viruses-hepatitis a and e,rotavirus,norvovirus, 3.protozoa- cryptosporidium,cyclospora,entamoeba,giardia,t gondii 4.trematodes,cestodes and nematodes
  • 8. FOOD BORNE PATHOGENS- TOXINS AND CHEMICALS Toxins-marine biotoxins,tetrodotoxin(pufferfish),pyrrolizidine alka,mushroom toxins,shellfish toxins,mycotoxins,plant toxicants Chemicals-pesticides(opp,sb),radionuclides,nitrites(food preservatives),toxic metals- cd,cu,hg,pb,sn,fluoride,MSG
  • 9. PATHOGENESIS AND TRANSMISSION Infectious agent or contaminant Inoculum/size of infective dose-can be as small as 10-100 bacterial cysts for shigella,EHEC,giardia,E.histolytica or 10^ 5- 10^ 8 for vibrio cholera,variable for salmonella Animals or humans harbouring infectionshed in fecescontaminate water,fruits,vegetablesinadequate cooking/improper storageinfection Warm temperature(10-50 degree cent.)- multiplication of pathogens
  • 10. SOME COMMON BACTERIAL FOOD POISONS Incubation cause symptoms Common period foods 1-6 hours Staph Nausea,vo Milk n milk aureus(ent mitting,diarr products,ha erotoxin) hea m,poultry,s alads,custa rds Bacillus Nausea,vo Fried rice cereus(ent mitting,(em erotoxin) etic form)
  • 11. SOME COMMON BACTERIAL FOOD POISONS Incubation Cause symptoms Common period foods 8-16 Clostridium Abd.cramps, Meat, hours perfringes diarrhea poultry, (spores) Nausea and legumes. vomitting-rare gravies Bacillus Diarrhea,abd. cereus(diarrhe pain,nausea, al form- No preformed n vomitting/fever stable toxins)
  • 12. SOME COMMON BACTERIAL FOOD POISONS Incubation cause symptoms Common period foods >16 hours Vibrio Rice watery Water and cholera stools ice creams,sea food Salmonella Inflammato Meat,milk n spp ry diarrhea milk products,po ultry Shigella sp dysentry Potato/raw eggs-salad
  • 13. EARLY DIAGNOSIS AND INVESTIGATIONS 1.Initial assessment of cases-Detailed clinical history including time of onset,duration of illness,symptoms,h/o travel,recent meals,cooking and refrigeration,details of others with similar complaints 2.Detailed clinical examination-vitals and degree of dehydration,systemic signs
  • 14. LAB DIAGNOSIS Main objectives- a)To confirm clinical diagnosis by isolation of causative agent from proper samples,eg- stool,vomitus/gastric aspirate,food specimens b)Ensure proper identification of disease c)Determine causative agent if present in food sources with relevant epidemiological markers-eg Biotyping,serotyping,pcr,phage typing etc