Unit 11 Bacterial Food Infections: Structure
Unit 11 Bacterial Food Infections: Structure
Unit 11 Bacterial Food Infections: Structure
Infections
11.0 Objectives
11.1 Introduction
Zoonotic Diseases
11.2 Salmonellosis
11.3 Escherichia coli gastroenteritis
11.4 Bacillus cereus gastroenteritis
11.5 Cholera
11.6 Vibrio parahaemolyticus gastroenteritis
11.7 Shigella dysentery
11.8 Campylobacteriosis
11.9 Yersiniosis (Yersinia enterolytica infection)
11.10 Listeria monocytogenes infection (Listeriosis)
11.11 The Most Important Point to Remember to Wash you Hand
11.12 Let Us Sum Up
11.13 Key Words
11.14 Answers to Check Your Progress Exercises
11.15 Some Useful Books
11.0 OBJECTIVES
After reading this unit, you will be able to:
• describe major bacteria causes food born infections
• explain the mode of transmission of the food borne infection, symptoms
and preventive measures.
11.1 INTRODUCTION
Food infection occurs when a pathogen enters the gastrointestinal tract and
multiplies. Microorganisms can penetrate into the intestinal mucosa and grow
there, or they can pass through other systemic organs. Infections are
characterized by a delay in the appearance of gastrointestinal disturbance while
the pathogen increases in numbers or affects invaded tissue. There is also
usually a fever, one of the body’s general responses to an infective organism.
Foodborne infections remain a major public health problem. The Council for
Agricultural Science and Technology estimated in its 1994 report, Foodborne
Pathogens: Risks and Consequences, that as many as 9,000 deaths and 6.5 to
33 million illnesses in the United States each year are food-related.
39
Food Poisoning
11.2 SALMONELLOSIS
Salmonellosis is the most reported zoonotic disease in European countries.
Salmonellosis (Salmonella gastroenteritis) results from the ingestion of foods
that contain significant numbers of viable cells of the members of the genus
Salmonella. It is the most frequently occurring food borne infection.
Salmonella are small gram negative, motile, non-spore forming rods that
ferment glucose, usually with gas, but usually do not ferment lactose or
sucrose. They are widely distributed in nature, with humans and animals being
their primary reservoir. Generally large number of salmonellae typically 106 to
109 bacterium must be ingested to cause illness.
Occurrence: The initial source of the bacteria is the intestinal tract of animals
such as birds, reptiles, farm animals, humans and occasionally insects. As
intestinal form, the organisms are excreted in feces from which they maybe
transmitted by insects and other living creatures to a large number of places,
polluted water and contaminated food. The organism may get transferred from
actual infected cases of the disease or from carriers. A carrier is defined as a
person or an animal that repeatedly sheds bacteria, usually through feces,
without showing any signs or symptoms of the disease. Infected rodents, rats
and mice may contaminate unprotected foods with their feces and thus spread
Salmonella bacteria. Flies may play an important role in the spread of
Salmonella, especially from contaminated fecal matter to foods. Humans
acquire the bacteria from contaminated food such as beef products, poultry,
eggs, egg products or water.
Symptoms: The susceptibility of humans varies with the species and strains of
the organism and the total number of bacteria ingested. A longer incubation
period usually distinguishes salmonellosis from staphylococcus poisoning:
40usually 12-36 hours for the former and about 2-4 hours for the latter. The
Bacterial Food
Infections
principle symptoms of a salmonella gastroenteritis infection are nausea,
vomiting, abdominal pain and diarrhoea that usually appear suddenly. This
may be preceded by a headache and chills. Other evidences of the disease are
watery, greenish-fowl-smelling stools, prostration, muscular weakness,
faintness, usually a moderate fever, restlessness, twitching and drowsiness. The
mortality is less than 1%. Intesibility may vary from slight discomfort and
diarrhoea to death in 2 to 6 days. About 0.2 to 5.0% of the patients may
become carriers of the Salmonella organism. During the acute phase of the
disease, as many as one billion salmonellae can be found per gram of feces.
Associated foods: Raw meats, poultry, eggs, milk and dairy products, fish,
shrimp, coconut, sauces and salad dressings, cake mixes, cocoa, peanut butter
and chocolate.
Conditions Necessary for Outbreak
The food must contain or become contaminated with the Salmonella bacteria.
These bacteria must be there in considerable numbers i.e., food should be a
good culture media, temperature favourable and enough time allowed for
appreciable growth.
The viable organism must be ingested.
Prevention of Outbreak: The control of food borne salmonella infection
requires the following:
1. Preventing food contamination by human carriers, especially food handlers.
2. Avoiding the use of animal products from domestic livestock that are
grossly infected with salmonellae.
3. Avoiding the use of food ingredients that contain salmonellae.
4. Processing all foods susceptible to Salmonella contamination at time-
temperature schedules sufficient to destroy the organism. Heating foods so
that all portions reach 66ºC for 12-15 minutes will assure destruction of
even most resistant Salmonella types.
5. Refrigerating all foods susceptible to Salmonella contamination and
avoiding prolonged holding of these foods at room temperature.
41
Food Poisoning
is around 2 days after eating the contaminated food and may last for 8 days.
Common symptoms included are cramps, chills, vomiting, aches and headache.
Associated Foods: E. coli is the etiologic agent of food poisoning involves
variety of foods such as cream pie, mashed potatoes, cream puffs and creamed
fish. Other E. coli food poisoning outbreaks have been attributed to the
consumption of milk, cheese, ice cream, meats, fish and macaroni. E. coli is
relatively sensitive to destruction by drying or freezing but some survivors may
exist for extended periods.
“Enteropathogenic” strains colonize in the small intestine and cause acute
gastroenteritis in newborns and in infants up to two years of age.
“Enteroinvasive” strains invade the epithelial cells of large intestine and cause
diarrhoea in older children and adults. “Enterotoxigenic” (enterotoxin
producing) strains produce one or both of two different toxins:a heat stable
toxin (ST) and a heat labile toxin (LT). Both toxins cause diarrhoea in adults
and infants. Enterotoxigenic strains of E. coli are often associated with
Travellers’ diarrhoea, a common disease contracted by tourists when visiting
developing countries. Diagnosis of travellers’ disease is based on the past
travel history and symptoms. Laboratory diagnosis is by isolation of the
bacteria from feces. Treatment is with fluid and electrolytes. Other strains of E.
coli which are usually harmless in their normal habitat (the intestine) can cause
disease when they gain access to other sites or tissues. These diseases include
urinary tract infections, septic infections, bacteremia, meningitis, pulmonary
infections, abscesses, skin and wound infections.
Prevention and Control: Involves avoiding contaminated food and water that
have high coliform counts, avoiding unpasteurized juices, washing fresh fruits
and vegetables thoroughly before eating raw, using adequate cooking
procedures for destruction and prompt refrigeration. Most people recover from
E. coli infection within 5-10 days without treatment. Antibiotics and
antidiarrhoeal drugs are usually not helpful.
42
Bacterial Food
Infections
11.5 CHOLERA
Cholera is caused by the gram negative, V. cholerae, which is acquired by
ingesting food or water contaminated by fecal material from patients or carriers
(shellfish and plankton may be the natural reservoir).
Symptoms: Once the bacteria enter the body, the incubation period is from
several hours to three or more days. An infective dose of around one million
organisms should be ingested to cause illness. The bacteria adhere to the small
intestine wall, where they secrete the cholera enterotoxin, choleragen. As a
result, there is hyper secretion of water and chloride ions, while inhibiting
absorption of sodium ions. The patient experiences an outpouring of fluid and
electrolytes with associated abdominal muscle cramps, vomiting, fever and
watery diarrhoea. The diarrhoea can be so profuse that a person can lose 10-15
liter of fluid during the infection. Death may result from the elevated
concentration of blood proteins, caused by reduced fluid levels, which leads to
circulatory shock and collapse. Onset of the illness is generally sudden, with
incubation periods varying from 6 hours to 5 days.
Associated Foods: Cholera is generally a disease spread by poor sanitation,
resulting in contaminated water supplies. Sporadic cases occur when shellfish
harvested from fecally polluted coastal waters are consumed raw.
Diagnosis: Cholera can be confirmed only by the isolation of the causative
organism from the diarrheic stools of infected individuals.
Prevention: Following recommendations are there to prevent cholera
outbreak:
• Drink only water that you have boiled or treated with chlorine or iodine.
Other safe beverages include tea and coffee made with boiled water and
carbonated, bottled beverages with no ice.
• Eat only those foods that have been thoroughly cooked and are still hot, or
fruit that you have peeled yourself.
• Avoid undercooked or raw fish or shellfish.
• Make sure all vegetables are cooked, avoid salads.
• Avoid foods and beverages from street vendors.
A simple thumb rule is “Boil it, cook it, peel it, or forget it”.
Control: Individuals infected with cholera require oral rehydration therapy
with NaCl plus sucrose, sodium bicarbonate and potassium chloride to
stimulate water uptake by the intestine. The antibiotics of choice are a
tetracycline or aproflaxin. The most reliable control methods are based on
proper sanitation, especially of water supplies. The mortality rate without
treatment is often over 50%. Medical treatment to prevent dehydration prevents
all complications.
43
Food Poisoning
#
Check Your Progress Exercise 1
Note: a) Use the space below for your answer.
b) Compare your answers with those given at the end of the unit.
1. Briefly discuss the Salmonella food infection.
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
2. How do you prevent food borne infection?
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
11.7 SHIGELLOSIS
Shigellosis or bacterial dysentery, is caused by facultatively anaerobic, gram-
negative, non-spore forming, rod-shaped organisms belonging to the genus
Shigella within the family enterobacteriacae. In general, shigellosis is a self-
limiting disease, lasting 5 to 6 days if untreated, however in young
malnourished children, the elderly and the immuno compromised (eg, AIDS
patients), the disease may be fatal. It is estimated that shigellosis is responsible
for the death of 500,000 children worldwide each year. There are many points
of similarity between Shigella and Salmonella. They dwell primarily in the
gastrointestinal tract, with optimum temperature of 37ºC, grow both aerobically
and anaerobically they grow freely in warm, bland, moist foods. But unlike
salmonellae, the shigellae have no flagella and thus are non-motile. The species
involved are Shigella sonnei, S. dysenteriae, S. flexineri and S. boydii. As few
as 10cfu of S. dysenteriae are known to initiate infection in susceptible
individuals. The illness caused by Shigella accounts for less than 10% of the
reported outbreaks of food borne illness in US. The organisms tolerate salt
concentration of 5-6% and are relatively heat sensitive.
Occurrence: Poor personal hygiene is a common factor in food borne
shigellosis, with shellfish, fruits and vegetables, chicken and salads being
prominent among vehicle foods. The prominence of these foods is due to the
fecal-oral route of transmission. Outbreaks have been also traced to foods such
as chocolate pudding, salads.
Symptoms: Pathogenicity involves the release of lipopolysaccharide endotoxin
which infects the intestinal mucosa. Shigellosis ranges from fairly mild to very
severe and fatal. The onset is usually abrupt, requiring from 1-7 days of
incubation, but sometimes requiring as many as 14 days. Symptoms are
abdominal pain and cramps caused by inflammation of mucus surface of large
intestine, nausea, diarrhoea, vomiting, elevated temperature. The mortality
associated with S. dysenteriae infection is around 20% but it is much lower
with other species. In severe instances, excessive diarrhoea leads to electrolytic
imbalance in the bloodstream and ulceration in large intestine. There may be
kidney failure, jaundice and persistent internal bleeding. The infection is
localized and organs other than the large intestine are not invaded.
Diagnosis: Serological identification of culture isolated from stool helps to
diagnose the disease.
Prevention and Control: The control of Shigella food borne infection is
similar to that of salmonellae; avoiding contamination of foods by animal or
human carriers or their excrement, thorough cooking and prompt cooling.
Proper personal hygiene should be maintained. In severe cases of shigellosis,
dehydration of the body may necessitate intravenous replacement of fluid with
electrolytes. Ampicillin antibiotic can decrease the duration of the disease.
11.8 CAMPYLOBACTERIOSIS
It is caused by Campylobacter jejuni, a Gram negative rod. It is a
microaerophillic organism, which means it has a requirement for reduced levels
of oxygen. It is often isolated from healthy cattle, chickens, birds and even
45
Food Poisoning
47
Food Poisoning
Aerial Aerial
contamination contamination
ANIMAL PRODUCTS
Milk, meat, carcass, dairy
products
48
Bacterial Food
Infections
Check Your Progress Exercise 3 "
Note: a) Use the space below for your answer.
b) Compare your answers with those given at the end of the unit.
1. What is yersiniosis? Give its symptoms.
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
2. How is L. monoctogenes infection transmitted?
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
51
Food Poisoning
53