Types of food poisoning

The body is very clever! When it detects that you have eaten something harmful, it tries to
get rid of whatever has caused the problem by the quickest method - and we don't need to
explain in any detail what this often entails!
However most cases of food poisoning are not reported because
people suffer "mild symptoms" and recover fairly quickly, but as
a result, the exact causes of food poisoning is not always tested
for.
The Food Standards Agency indicate some frightening statistics,
in that each year in the UK:

around a million people suffer a food borne illness

around 20,000 people receive hospital treatment due to
food borne illness

there are around 500 deaths caused by food borne illnesses

the cost of food safety and hygiene issues in the UK is nearly 1.5 billion!!
In the coming sections, we will therefore identify the many types of food poisoning and some
of the most common symptoms that result.

Campylobacter is by far the most common cause of food poisoning and is found in:

raw poultry

uncooked meat

unpasteurised milk

untreated water
Campylobacter will be destroyed through the cooking
process and through the pasteurisation of milk.
Pets with diarrhoea can be a cause but the majority of
infections remain unexplained by recognised risk factors for
disease. The most common signs and symptoms include:

headache

fever

severe abdominal pain

diarrhoea
Symptoms may normally take 2 to 4 days to appear and can return after a few weeks.

Salmonella
Salmonella is the second most common cause of food poisoning. Outbreaks can occur in
the general population (and within institutions) but
fortunately, serious cases are infrequent.
Salmonella has been found in:

raw meat

poultry

eggs

unwashed vegetables
but not exclusively, as it can be found in many
other types of food!
It is carried in the gut and faeces of animals and humans and transmission occurs by the
ingestion of contaminated food, or through faecal contamination from an infected person or

animal. People may also be exposed to salmonella through contact with household pets,
especially reptiles (e.g. lizards, turtles, snakes).
The most common signs and symptoms include, abdominal pain, headache, fever, vomiting,
watery and sometimes bloody diarrhoea.
Infection are likely to cause severe illness in the young, old or sick. Symptoms can take
between 12 and 48 hours to develop and illness can be severe and in some cases fatal.
Complications include scepticaemia or reactive arthritis.
Freezing foods contaminated with salmonella hinders the growth of the bacteria but will NOT
destroy it!

E.Coli and its symptoms

E.Coli can be found in:

unpasteurised milk and dairy products

raw vegetables

unpasteurised apple juice

raw and undercooked meat

In recent years, outbreaks have been reported where
contaminated food has been: mince, milk, yoghurt,
cooked meats, meat pies, cheese and dry cured salami.
E.Coli exists in the guts of animals and humans and there
are different types/strains. Some are harmless, whilst
others are capable of causing common infections such as urine infections and infections of
the gut (like gastroenteritis) and much more serious illnesses. Symptoms may take
anywhere between 1 to 2 weeks to develop, but would normally take about 2 days. The main
symptom is diarrhoea, which may be bloody and severe and in the elderly and children
under 6, could lead to kidney failure and sometimes death.
An uncommon type of infection which can cause serious illness is Verocytotoxin producing
E.Coli 0157. This can cause a severe gut infection. Also the toxin (poison) which is released
by the VTEC 0157 can cause other serious diseases. Most people will recover but it is
sometimes fatal. Healthy sheep and cattle can sometimes carry VTEC 0157 and there have
been links to people who have worked and handled live sheep and cattle. In Lanarkshire,
there was an outbreak in 1996, killing 20 people and hospitalising 100!
It is really important that people who are infected with E.Coli do not pass this bacteria on to
others due to poor hygiene, such as not washing hands after going to the toilet and then
preparing food. The bacteria can survive refrigeration and freezer storage, but thorough
cooking of food and the pasturation of milk will kill them.

Less Common Types

There are many more strains of bacteria and micro-organisms which have been identified as
causes of food poisoning.
Other bacteria which are not as common but that can also cause food poisoning include:

Clostridium perfringens - common source may be from animal and human excreta,
soil, dust, insects, raw meat and will be linked to cooked meat and poultry.

Listeria - common source may be soil, water, sewage, people and will be linked to
soft cheese, cheese made from unpasteurised milk, salad and pt.

Bacillus cereus - common source may be from cereals, soils and dust and will be
linked to cerials (especially rice).

Staphylococcus aureus - common source may be from the human body, especially
skin, nose, mouth, cuts and boils and will be linked to cold meats, raw milk
(unpasteurised milk) and dairy products and anything touched by hand.

Norwalk-like viruses - common source may be from contaminated water or eating

meat from an animal that is infected or from a food handler that is infected with the virus and
will be linked by saliva, air, cough, fecal-oral route, surfaces, blood, needles, blood
transfusions, sexual contact and mother to

The Symptoms

Your body's defence when it has detected that

you have eaten something harmful is to get rid of it in the quickest manner. This means that
the most common symptoms of food poisoning are:

abdominal pains

diarrhoea

vomiting

nausea and fever

Incubation periods vary widely (depending on the cause of food poisoning) but most
pathogenic bacteria make you ill when they have been inside your body for a while. Others

may make you ill fairly soon after you have eaten, producing symptoms and illness within 30
minutes to a few hours, however most cases take between 1 and 2 days to develop.
If the food poisoning is due to an infection with Campylobacter, it may take a week or longer
to develop

Vulnerable Groups
It is important that all food handlers, in whatever profession, are aware of the members of
the population that are vulnerable to the risk of food poisoning.
If a person has a lowered resistance to disease, then food
poisoning will be more likely to affect them than a healthy person
who may also show fewer symptoms or no symptoms at all.
Anyone with a lowered or compromised immune system is at far
greater risk from food poisoning, as they do not have the
defences to cope with the pathogens which healthier individuals
may not even notice.
All the below groups have a compromised immune system and
are at greater risk:

Elderly people (over 60's) - as people age, their immune

systems do not respond as quickly and effectively and
have begun to deteriorate

Sick people; as their immune system has been impaired by other illnesses

Babies; as their immune system has yet to develop

Young children (under 5's); as their immune system is not developed sufficiently

Pregnant women

Groups of elderly and young people e.g. those in care homes, hospitals and care
centres, childrens nurseries, maternity wards

Food Allergies
People can be sensitive to certain foods and become ill after eating products that may not be
harmful to other people, such as those containing certain nuts or seeds. A reaction of this
kind is called a food allergy and can either happen within minutes of eating a product or in
some more severe cases, can happen as a result of simply coming into contact with the
product.
Whilst some reactions are mild, others can be fatal if medical treatment is not given
immediately. One such reaction is called anaphylactic shock and is life threatening.
The symptoms of food allergies may be:

sickness

diarrhoea

abdominal cramps

rashes

tingling of the lips, tongue and throat

swelling of the throat and mouth

difficulty in breathing or speaking

Most people who have a food allergy know what to avoid, but may need help in identifying
the ingredients and be able to trust the information given to them. This is why accurate food
labelling is so important and although you may think that some of the labeling on the packets
of food or drink you may be using or loading into a vending machine are not necessary - to
some people they are VITAL!
If you are preparing, using or handling food that may be an allergen, it is important to take
steps to ensure that you do not provide the allergen with a vehicle by which it contaminate
other foods that are intended to be allergen free.

Hazard Analysis Critical Control Points (HACCP)

Hazard Analysis Critical Control Point (HACCP) is a way of managing food safety. It is based
on putting in place procedures to control hazards and involves:

Looking closely at what you do in your business and what could go wrong

Identifying the critical control points- these are the places you need to focus on
to prevent hazards or reduce them to an acceptable level

Putting in place procedures to make sure hazards are controlled at your critical
control points

Deciding what action you need to take if something goes wrong

Making sure that your procedures are working

Keeping appropriate records to show that your procedures are working

Some people think that HACCP is very complicated, but it doesnt have to be.
The important thing is to have safety management procedures that are appropriate for
your business or place of work. To support this, there are packs produced by the Food
Standards Agency that can help you put procedures in place.

What is a hazard

A hazard is something that could make a

situation, product or environment dangerous. When considering hazards in relation to food, a
hazard is something that could make a food unsafe to eat and can happen at any stage
within the food Chain from delivery to food service.
Food safety hazards can be:

Microbiological - involving harmful bacteria, e.g. when certain foods are kept out of
the fridge for too long and bacteria will grow in them

Chemical - involving chemicals getting in the food, e.g. cleaning products or pest
control chemicals

Physical - involving objects getting into food, e.g. broken glass or pieces of
packaging

What the Law says about procedures

You must put in place 'food safety management procedures' and these could be based on
the principles of HACCP (Hazards Analysis Critical Control Point)
You must also:

Keep these in place permanently

Keep up to date documents and records relating to your procedures

Review your procedures if you change what you produce or who you work in
association with

Personal Responsibilities and Duty of Care

Both employers and employees have

responsibilities under the law regarding food safety and hygiene.
As an individual, you have a duty of care and as a result, it is your responsibility to
ensure that your behaviour and standards of hygiene do not knowingly cause a
breach of these regulations.
Failure to do so can result in fines being issued to both you and your employer.
Regulations do change from time to time, so it is also very important to keep up to
date with the current standards and expectations. We will take a look at some of
these a little later in the course.

Well Done

You have demonstrated your understanding of key points to know in

this section

Now move on to the next section.

Can you see germs on contaminated food with the naked eye?

You said: No
Correct

Germs are normally only visible under a microscope

4493

All bacteria are harmful. Is this statement True or False?

You said: False

Correct

Some are essential for a healthy life!

4494

Bacteria grow rapidly in cold, dry conditions. Is this statement True or False?

You said: False

Correct

Bacteria multiply at a fast rate and to do so they need moisture, food, warmth and
time

4495

Is it true to say that at very low temperatures bacteria will always die?

You said: No
Correct

Some will die but many will survive and when the warm conditions return, they will
start to multiply.

4510

Food poisoning only happens in isolated cases and to individual people at a time. Is
this statement True or False?
You said: False
Correct

Groups of people can often be infected e.g. at a social function, where many people
could eat contaminated food and all become ill.

4497

Do Environmental Health Officers have the power to prosecute?

You said: Yes

Correct

If offenders break the law, they can be prosecuted.

4498

Food poisoning is only caused by bacteria and viruses

You said: False

Correct

Food borne illness can also be caused by toxins and chemicals, for instance
pesticides that can remain on food and cause illness.

4499

People who eat a high protein diet are most vulnerable to food poisoning. Is this
statement True or False?
You said: False
Correct

People with a weak or underdeveloped immune system are most vulnerable.

4500

Hazard Analysis Critical Control Point (HACCP) is a way of managing food safety
and is based on putting procedures and controls in place. Is this statement True or
False?
You said: True
Correct

All food premises owners are required to have procedures and controls in place to
help with food safety and hygiene.
As different food poisoning germs are active at different temperatures (as discussed earlier
in this course) it is important to keep foods below 5C or above 63C. Outside this range,
most germs are dormant and will not multiply.
Please see below a guide to the correct temperature controls:

Correct Temperature Controls

Fridge
Freezers
Cooking Food
Serving Hot Food

Unhygienic Check List

Here is a check list of things that

should NEVER be done when working as a food handler.

You should NEVER:

chew

cough

smoke

sneeze

eat or drink

spit

scratch

lick fingers

blow on glasses or cutlery to help polish them

dry your hands on your clothing or on cleaning cloths

bite nails

handle food too much

pick at your face (spots)

leave cuts or sores uncovered

wear strong aftershave or perfume

wear earrings, hairgrips, rings, bracelets or wristwatches

wear nail vanish or false nails

This is an important check list and you should try to make sure you understand and
remember as much of this information as possible!

Personal Appearance

It is so important that you maintain high

standards of personal appearance. Whilst at work you are a representative of your
organisation and seen as such by the public and your clients/customers so remember, first
impressions are always important (for you and the organisation you work for) as it can
ensure you demonstrate:

a professional image

high standards

safe working practices

that you care and that the impression of clients/customers is important to you
It is also important to always follow good practice so as a person involved in the food chain
consider the points below:

wash your hands thoroughly

keep yourself and your uniform clean

wear strong and sensible shoes

keep your nails clean

keep your hair clean and tidy

cover cuts with a waterproof dressing- a blue one is ideal

at all times show due diligence

Knowledge Check !
Well Done

You have demonstrated your understanding of key points to know in

this section

Now move on to the next section.

It is a legal requirement to report to your supervisor if you have had food poisoning or
have been in contact with someone suffering from food poisoning or an air borne
disease. Is this statement True or False?

You said: True

Correct

It is a legal requirement under the Health and Safety at Work Act 1974

4501

Should you wear protective clothing outside of a "food environment" or to go to the

toilet?

You said: No

Correct

Protective clothing should NEVER been worn under these circumstances

4504

If you work in a food preparation/handling environment and cut yourself, you should
wear which of the following?

You said: A brightly coloured waterproof plaster which completely covers the
wound.

Correct

It must be waterproof and brightly coloured so that you can easily see if it has fallen into any
food.

4505

The standards of personal hygiene that I maintain are my own business. Is this
statement True or False?

You said: False

Correct

Personal hygiene standards are essential and food handlers should follow all relevant
guidelines in following them!

4506

An interesting fact is that germs can live on our hands for up to how long?

You said: 3 hours

Correct

Germs can live on our hands for 3 hours - that is why hand washing is so important.

4507

Rinsing hands under hot water will remove the germs you may have picked up after
touching raw food.

You said: False

Correct

You must was hands thoroughly with soap, using the RCN approved method.

4509

Bacteria do not multiply between temperatures of 0C and 5C, or if they do multiply,

they multiply very slowly. Is this statement True or False?

You said: True

Correct

Bacteria lie dormant at temperatures between 0C and 5C, or if they do multiply,

they multiply very slowly.

4513

Freezers should operate at which of the following temperatures?

You said: -18C or below.

Correct

Freezers should operate at -18C or below.

4514

As with all equipment, fridges and freezers must be checked and maintained
regularly to ensure they are working correctly. Is this statement True or False?

You said: True

Correct

Ideally, refrigerator and freezer temperatures should be checked twice a day.

Avoid Cross Contamination

If you remember from earlier in the course, cross contamination is when bacteria is spread
between food, surfaces, people or equipment and we need to remember that anything that
touches food is a possible vehicle by which contamination could occur.
Here is an example of how you could spread bacteria, cross-contaminating items or
environments very quickly (that could possibly result in an incident of food poisoning).
As we have established, it is the elderly, young or ill who are at the highest risk of food borne
illness, so imagine that you have been preparing raw food in the kitchen and need to wipe
your hands. You use a tea towel that is for drying the dishes. You put it down and someone
else picks it up (without knowing) and wipes a dish clean. When food is put on to the plate,
bacteria will contaminate the food and the client/customer will be served food that could
result in them getting food poisoning.
You can see how easily it could happen, so remember - always be aware of using the
correct cloths. It would be good practice to use a colour code system for any equipment and
cloths that are used for cleaning purposes. This would then ensure that they will not be used
in inappropriate environments. For example, cloths and brushes for the toilet should NOT be
used in food areas.

Access Procedures

When entering a kitchen or food preparation area, anyone

NOT directly involved in food preparation or food handling should:

Wear appropriate protective clothing

Wash their hands effectively before entering

Not participate in any food preparation

Be supervised at all times

From time to time, premises may be visited to ensure you can demonstrate that you comply
with hygiene regulations. This could include:

Inspectors - who may wish to check that legal requirements are being met

Managers - who may visit to routinely check standards

Pest control officers - who will check to ensure there is no evidence of infestation

Recognising pests
Pests can be broadly classified as:

those which live or feed on foodstuffs or waste

in your kitchen, causing damage and /or
contamination

Product Pests, which make a home inside

your food.
Food pest creatures include:

Domestic pets

Rodents: rats, mice

Birds: pigeons, starlings, sparrows, seagulls

Insects: flies, cockroaches, moths, ants, wasps

Stored product pests are mainly insects and include:

Beetles

Mites

Weevils
All of the above love overfilled bins, waste areas, food areas that have not been secured
properly and dirty premises, all of which make ideal places to breed.

Signs of Infestation
Tell-tale signs of pests may result in you noticing:

Actual live or dead pests

Droppings

Fur or feathers

Eggs or egg cases

Damaged food packages

Bad smells

Skin bites

Gnawed wires

Nests

Movement tracks
You may be able to think of some other signs that may indicate that pests have been

Preventing Infestation

The best way to control a pest infestation is

not to let it happen in the first place! Always follow best practice to control access for pests,
such as:

Attach fly screens to windows

Block gaps around service areas

Use gutter guards

Fit door strips and plates

Eliminate access to waste food and shelter

Keep all areas clean and disinfected

Never leave food debris around

Cover milk deliveries

Ensure that all waste is disposed of in tight fitting bins

Keep food off the floor

Keep food in air tight containers if kept in cupboards (eg.flour)

Keep water tanks covered

Infestation can lead to the spread of disease and for the sick, elderly or young, can be very
dangerous. It can also lead to food stocks being damaged, which can be very costly as it will
all have to be thrown away if it has become contaminated. You may also get customer

complaints which could lead to loss of business and in the worst cases, businesses can be
forced to close with the potential for legal action!
The consequences of pest infestation can be quick to remedy if caught early enough but can
similarly be extremely serious if left untreated!

Well Done
You have demonstrated your understanding of key points to know in this
section
Now move on to the next section.

Why is it important to clean as you go?

You said: It is a routine that will enable you to stay on top of safety and hygiene
issues

Correct

It is a routine that will enable you to stay on top of safety and hygiene issues.

4516

When preparing cleaning agents which of the following best describes why water should
always be put into the bucket or bottle first?

You said: It helps to reduce splashing and minimises the risk of neat chemical coming
into contact with the skin

Correct

If chemicals are added afterwards (against specific instructions) it helps to reduce

splashing and minimises the risk of neat chemical coming into contact with the skin

of the handler, other people and surfaces around.

4517

Food safety laws require organisations involved in food preparation and handling tasks to
have a cleaning schedule. Is this statement True or False?

You said: True

Correct

Food safety laws require organisations involved in food preparation and handling
tasks to have a cleaning schedule.

4518

Which of the following best describes cross contamination?

You said: Cross contamination is when bacteria is spread between food, surfaces,
people or equipment

Correct

Cross contamination is when bacteria is spread between food, surfaces, people or

equipment. Anything that touches food is a possible vehicle by which
contamination could occur.

4519

Which of the following is the best reason why controlling access to food handling/preparation
areas is important?

You said: To minimise the risks of contamination and cross-contamination

Correct

Food handling/preparation areas should be for food handlers only, as this will help to
minimise the risks of contamination and cross-contamination.

4520

Which of the following is true about animals in food preparation areas?

You said: Animals are not allowed at all

Correct

No animals are allowed in food preparation areas!

Health & Safety at Work Act etc 1974

This important act imposes duties of care on both employers

and employees, which cover the responsibilities of both employers and employees. It makes
you responsible! For Employers, the following is expected. They should:

Make the workplace safe, without risks to health (this includes keeping dust and
fumes under control; ensuring substances are stored and used safely; giving employees

adequate information, instruction, training and supervision necessary for their health and
safety), and ensuring an employees' welfare, so far as 'reasonably practicable'.

Draw up of a health and safety policy and ensuring everyone is aware of it and what
it means.

Provide protective clothing specifically required by health and safety law free of
charge.

Report injuries, diseases and dangerous occurrences to the appropriate authorities.

Keep the workplace clean, providing clean washing and toilet facilities and
accommodation for clothing.

Take correct precautions to prevent employees being exposed to substances which

may damage their health.

Ensure that all substances, including micro-organisms are safe (as far as is
reasonably practicable) and without risks to health.

Employees' Responsibilities

Under the Health and Safety at Work Act 1974, employees

have responsibilities too! It is an employee's responsibility to :

Take reasonable care of the health and safety of themselves and of other persons
who may be affected by their acts or omissions at work.

To co-operate with employers and/or others carrying out legal requirements, as

necessary, so that the requirement can be performed or complied with.
Failure to observe these requirements can lead not only to the owner of the premises being
prosecuted, but also individual food handlers who do not follow required procedures.
Prosecution can result in

Fines of up to 20,000 for EACH offence

A prison sentence of up to 2 years.

Compensation to customers who have been affected by your

The Food Safety (General Food Hygiene) Regulations 2005 became law in January
2006.
One of the most important features of this Regulation is the requirement for Food
Business Operators to put in place management procedures and controls around
food safety. These might be based on Hazard Analysis Critical Control Point
(HACCP) principles that we looked at a little earlier in this course.
The Regulation requires appropriate food safety management arrangements so that
you and your employer are be able to show that you have done whatever possible
to ensure the food prepared is safe to eat and that records exist

Employer's Obligations
As the proprietor of a food business, you should:

make sure food is supplied or sold in a hygienic way;

identify food safety hazards;

know which steps in your activities are critical for food safety;

ensure safety controls are in place, maintained and reviewed.

Controls dont need to be complex but should follow a recognised system for example,
Hazard Analysis and Critical Control Points (HACCP) which we looked at a little earlier in this
course. As a result, employers or anyone in charge of premises where food is prepared, are
duty bound by this legislation to make sure that:

The premises are registered with the local enforcement authority.

The premises are designed and equipped to operate in ways which prevent
contamination and which avoid the development of illness.

The staff are trained and supervised to work hygienically.

There are procedures in place to manage food hazards.

Potential hazards are assessed and action is taken to prevent, stop, or reduce the
risks to food safety.

Procedures are reviewed and updated as necessary.

Procedures are written down.

Food Handlers Obligations

If you ever handle food, you must:

Keep yourself and your workplace clean

Wear suitable protective clothing

Do everything in your power to protect food from contamination

Follow temperature controls for storage, preparation, display and serving of food.

Report any illness or food poisoning symptoms to your supervisor immediately.

NOT work with food if you have any symptoms until your employer or doctor says it is
safe to do so

Due Diligence
All Food Handlers Must Be Diligent!
S21 of The Food Safety Act, 1990 states:
"It is a defence for the person charged, to prove that they took all reasonable
precautions and exercised all due diligence to avoid commission of the offence by
themselves or by a person under their control".
This means that there must be evidence to prove that food handlers have:

followed legal requirements and organisational policies and procedures.

received adequate training and knowledge of food safety

protected individuals from harmful infections and unsafe practices wherever possible.

appropriate awareness and potentially be able to spot symptoms of infections.

appropriate awareness and potentially be able to spot hazards.

reported any illness, infection and hazards to the relevant personnel.

records relating to food handling which are complete, accurate and legible.
If you do not have this evidence and you are accused of causing a food safety incident, you
have no defence. It is up to you to make sure that you adhere to all of the above!
4521

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