Incidence And Impact Of Foodborne Diseases

Question 1

How many cases of childhood diarrheal disease occur annually

Answer 1

1.7 billion

Question 2

How many children under 5 die from diarrheal disease each year

Answer 2

525,000

Question 3

General cause of childhood diarrheal disease

Answer 3

Food borne illness

Question 4

CDC estimates for people sick, hospitalized and dead from food borne diseases each year in U.S.

Answer 4

Sick = 48 million
Hospitalized = 128,000
Dead = 3,000

Question 5

What book stimulated passage of meat inspection act and pure food and drug act

Answer 5

The jungle by upton Sinclair

Question 6

5 opportunities for contamination

Answer 6

-production
-processing
-consumption
-retail
-distribution

Question 7

Microorganisms grow best at (pH, temperature, time, moisture)

Answer 7

-pH between 4.6-7.5
-within temperature danger zone of 40-140F
-time >4 hours
-moist environment (water activity greater than 0.85)

Question 8

Foodnet: general

Answer 8

Surveillance network
Monitors 8 pathogens in 10 U.S. states (15% of U.S. population)
Collaboration between CDC, USDA and FDA

Question 9

4 objectives of FoodNet

Answer 9

1. Determine the burden of foodborne illness in the United States
2. Monitor trends in specific foodborne illness over time
3. Attribute foodborne illnesses to specific foods and settings
4. Develop and assess interventions to reduce foodborne illnesse

Question 10

Top 8 food borne pathogens in foodnet (rank 1-10)

Answer 10

1. Campylobacter
2. Salmonella
3. Escherichia coli
4. Shigella
5. Yersinia
6. Vibrio
7. Cyclospora
8. Listeria

Question 11

Most common source of food borne illness outbreaks from food preparation

Answer 11

Restaurants

Question 12

Most common food commodity as source of food borne illness outbreaks

Answer 12

Mollusks

Question 13

Largest contributor to outbreak associated illness from 2009-2018

Answer 13

Plants (34%)

Question 14

2021 incidence of infections caused by food borne pathogens in 10 U.S. states (# infections, hospitalizations, deaths): FoodNet

Answer 14

Infection = 22,000
Hospitalizations = 5,000
Deaths = 150

Question 15

Trends in infections caused by food borne pathogens (3)

Answer 15

-underreported
-infection rates mostly unchanged during past 2 decades, but increasing for some food borne pathogens
-produce still major source of food borne illness

Question 16

number of illnesses and hospitalizations from food borne illnesses related to dairy productions consumption (per year)

Answer 16

760 illnesses
22 hospitalizations

Question 17

What percent of total illnesses and hospitalizations was due to consumption of unpasteurized milk and cheese (From a study)

Answer 17

95%

Question 18

Top factors in newly emerging foodborne illnesses (3)

Answer 18

• Human demographics & behavior - Aging population, Higher consumption of fresh fruits & vegetables , ‘Organic’ doesn’t mean safer ,More food consumed outside the home
• Technologies within the food industry - Food transported over longer distances, Larger production facilities, Point source contamination has greater impact
• International travel & commerce - ‘Traveler’s diarrhea’; Travelers often take food with them on trip

Question 19

Other factors in newly emerging foodborne illnesses (3)

Answer 19

-microbial adaptation
-economic development and land use
-shortfalls in public health education

Question 20

Infections definition: foodborne illness

Answer 20

• Pathogen enters the body and must grow to cause effect
• Can be bacterial, viral, parasitic, or fungal
• Typically have longer incubation periods and cause fever

Question 21

Intoxications definition: foodborne illness

Answer 21

• Preformed toxin enters the body and directly exerts effect
• Most foodborne toxins are bacterial in origin (but not all)
• Typically have shorter ‘incubation’ periods; not as
pyrogenic

Question 22

Major foodborne pathogens (10)

Answer 22

-bacillus cereus
-campylobacter jejuni
-clostridium botulinum
-clostridium perfringens
-enterohemorrhagic E. Coli
-hepatitis A
-listeria monocytogens
-norovirus
-salmonella enteric a
-staphylococcus aureus

Question 23

Salmonella: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and
major control measures.

Answer 23

type of organism - gram negative bacteria
commonly implicated food(s) - raw/imported pasteurized milk, raw meats and poultry, eggs
source of infection - domestic and wild animals (nontyphoidal), humans (typhoidal)
infection vs. intoxication- INFECTION
incubation period - 6-72 hours (GI), 1-3 weeks (typhoidal)
major symptoms (GI type/nontyphoidal) = nausea, vomiting, cramps, fever, diarrhea
Major symptoms (typhoidal) = very high fever, lethargy, RASH OF FLAT, ROSE COLORED SPOTS
major control measures - cook food thoroughly, hygiene during food handling, hand washing

Question 24

Nontyphoidal serotypes for salmonella

Answer 24

Zoonotic

Question 25

Typhoidal serotypes of salmonella

Answer 25

Humans only

Question 26

Only know reservoir for salmonella enteric typhoidal and Paratyphi

Answer 26

Humans

Question 27

What percent of all raw poultry samples culture positive for salmonella

Answer 27

33%

Question 28

Campylobacter jejuni: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures

Answer 28

type of organism - gram negative non spore forming bacteria commonly implicated food(s) - raw poultry, raw milk and cheeses, WATER source of infection - normal gut flora of most food producing animals (contaminates food and water) infection vs. intoxication - INFECTION incubation period - 2 to 5 days major symptoms - fever, nausea, water/sticky diarrhea with maybe blood, miscarriage or still birth, Gillian barre syndrome major control measures - hygienic slaughter, prevent cross contamination, refrigeration, don’t consume unpasteurized products

Question 29

How many pathogenic types of e. Coli are there

Answer 29

6

Question 30

Enterohemorrhagic Escherichia coli: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.

Answer 30

type of organism - gram negative bacteria commonly implicated food(s) - ground meats, raw milk, juices, fresh veggies, apple cider, yogurt, mayo source of infection - CATTLE, ruminants infection vs. intoxication - SHIGA TOXIN formed after ingestion of bacteria (not preformed) incubation period - 3 to 4 days major symptoms - hemorrhagic colitis (severe cramps, water to bloody diarrhea), hemolytic uremic syndrome in children major control measures - cook ground beef well, don’t consume unpasteurized, hand washing

Question 31

Listeria monocytogenes: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.

Answer 31

type of organism - gram positive bacteria (can grow in freezing temperatures!!!!) commonly implicated food(s) - raw milk, soft cheese, seafood, deli meats, raw veggies source of infection - livestock food and silage, handling and slaughter operations (causes neurologic disease in livestock) infection vs. intoxication - infection incubation period - hours to 3 days (GI), 3 days to 3 months (invasive) major symptoms - fever, nausea, vomiting (GI); stiff neck, confusion, loss of balance, abortions/stillbirths (invasive form) major control measures - NO RAW milk or dairy products from raw milk, no ready to eat foods, wash fresh fruits and veggies, cook meat

Question 32

Number of deaths from listeriosis is what % of all foodborne illness deaths

Answer 32

28

Question 33

Clostridium perfringens: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures

Answer 33

type of organism - gram positive spore forming bacteria commonly implicated food(s) - beef and poultry, Mexican foods, veggies source of infection - found in soil, contaminated by human or animal feces infection vs. intoxication - ENTEROTOXIN formed in intestine after ingestion incubation period - 16 hours (FAST) major symptoms - water diarrhea, highly fatal form called pig bel disease major control measures - refrigerate or eat foods soon after cooking, wash fruits and veggies

Question 34

pigbel disease form of clostridium perfringens: cause, effect, common in what country

Answer 34

Necrotizing enteritis Contaminated pork More common in Papa New Guinea

Question 35

What percent of people are healthy carriers for staphylococcus aureus

Answer 35

25

Question 36

Bacillus cereus: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.

Answer 36

type of organism - gram positive spore forming bacteria commonly implicated food(s) - rice (vomiting type), many foods for diarrhea type source of infection - soil, fecal oral contamination, bad hygiene, cross contamination infection vs. intoxication - INTOXICATION (vomiting type toxin is heat stable, diarrhea type is heat labile/susceptible) incubation period - 30 min to 6 hours (vomiting type), 6 to 15 hours (diarrhea type) major symptoms - nausea and vomiting (vomiting type), water diarrhea, abdominal pain, cramping (diarrhea type) major control measures - refrigeration, reheat foods thoroughly

Question 37

2 types of bacillus cereus

Answer 37

Vomiting Diarrheal

Question 38

Clostridium botulinum: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.

Answer 38

type of organism - gram positive commonly implicated food(s) - low oxygen foods (canned foods), honey source of infection - agricultural products (meats, produce, honey, fish), spores everywhere infection vs. intoxication - INTOXICATION, neurotoxin formed by bacterial phase incubation period - 18 to 26 hours after ingestion of preformed toxin major symptoms - double or blurred vision, slurred speech, difficulty swallowing, muscle weakness, infant botulism major control measures - boil canned foods for 10 minutes before eating, process foods below pH 4.6, don’t feed honey to infant

Question 39

Infant botulism: cause, symptoms

Answer 39

Caused by honey Constipation is first sign Flat facial expression, weak cry

Question 40

What is the most lethal natural neurotoxin known

Answer 40

From clostridium botulinum

Question 41

How can you inactivate spores from clostridium botulinum

Answer 41

Boil for more than 5 minutes

Question 42

Hepatitis A: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.

Answer 42

type of organism - RNA virus commonly implicated food(s) - person to person, contaminated water/shellfish source of infection - feces of infected people (fecal oral route of transmission) infection vs. intoxication - INFECTION incubation period - 30 days average (LONG) major symptoms - asymptomatic in children, initially have fever/nausea, jaundice days later major control measures - wash hands, hepatitis A vaccine

Question 43

case fatality rate of hepatitis A

Answer 43

2.4

Question 44

Norovirus: type of organism, commonly implicated food(s), source of infection, infection vs. intoxication, incubation period, major symptoms, and major control measures.

Answer 44

type of organism - RNA virus commonly implicated food(s) - any food prepared by infected person, shellfish grown in infected water source of infection - humans, contaminated water infection vs. intoxication - INFECTION incubation period - 24 to 28 hours (maybe 12 hours) major symptoms - recover in few days, explosive vomiting, headache, chills, 30% show no signs major control measures - hand washing, food handling

Question 45

What is the leading cause of disease outbreaks from contaminated food in the U.S (called the winter vomiting bug or 24 hour flu)

Answer 45

Norovirus

Question 46

Which 2 pathogens have very low case fatality rates

Answer 46

Listeria monocytogenes Salmonella enterica