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Similar a Foodborne Illnesses Wong 2007 July
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Foodborne Illnesses Wong 2007 July
- 1. Community Physician’s Role in Foodborne Illness Investigations Chicago Medical Society Chicago Department of Public Health Preparedness and Emerging Infections Training Program 2007
- 4. Burden of Disease Pyramid Person exposed to pathogen Person becomes ill Person seeks medical care Specimen obtained Lab test(s) done Test confirms case Case Reported
- 5. Burden of Disease Pyramid – Foodborne Illnesses Person exposed to foodborne pathogen Person becomes ill Person seeks medical care Specimen obtained Lab test(s) done Test confirms case Case Reported Estimated 76 million annually in U.S.
- 12. Usual Incubation Periods for Selected Foodborne Pathogens Hepatitis A Yersinia E. coli O157:H7 Campylobacter Shigella spp. Cyclospora cayetanensis Clostridium botulinum toxin Enterotoxigenic E. coli Norovirus Clostridium perfringens toxin Vibrio parahemolyticus Bacillus cereus toxin Staph aureus toxin Salmonella spp. Invasive disease Listeria GI disease 24h / 1day Hours Days 2 6 10 14 18 22 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46
- 14. Duration of Illness of Common Foodborne Pathogens Bacterial pre-formed toxins ( Bacillus , C. perfringens , Staph ) 24 – 48 hrs Viruses Norovirus Rotavirus and others 12 hrs – 5 days 2 – 9 days Bacteria Campylobacter E. coli Salmonella / Shigella 2 – 10 days 5 – 10 days 4 – 7 days Parasites Crypto , Giardia , Cyclospora, Entamoeba Weeks to months (may remit and relapse)
- 22. Some Food-Pathogen Associations Chicago Department of Public Health Unpasteurized Milk and Cheese Listeria monocytogenes Brucella spp. Fresh Produce Berries, Melon, Juice, Sprouts, Lettuce, Spinach, Tomatoes Cyclospora, E. coli, Salmonella Ground Beef E. coli (especially O157:H7)
- 23. Chicago Department of Public Health Pork Trichinella spiralis, Yersinia spp. Chicken Campylobacter, Salmonella Fried Rice Bacillus cereus Tuna Marlin Scombroid (histamine) Mahi Mahi Oysters Vibrio parahaemolyticus Eggs Salmonella spp.
- 24. Chicago Department of Public Health Deli Meats Listeria monocytogenes Hot Dogs Home-canned fruits and vegetables Botulinum toxin Ice Cream Salmonella spp.
- 32. Chicago Foodborne Outbreaks: Hospitalizations, Illnesses, & Evaluations 1997-2006 (N=116 outbreaks)
- 33. Chicago Foodborne Outbreaks: Etiologic Agents 1997-2006 (N=116) (60%) (17%) (15%) S. aureus , A. cantonensis , B. cereus , Ciguatoxin, E. coli O157, raphides
- 34. Chicago Foodborne Outbreaks: Detection Methods 1997-2006 (N=116) *FSE = Food Service Establishment, CD = Communicable Disease
- 42. http://www.elpasocitycountyhealth.com/environment/FoodInspection/FoodInspection.asp Sanitarians at work…
- 43. “ No, I’m not trying to sell you anything, sir. I’m investigating an outbreak and all I ask is two or three hours of your time to answer a few thousand questions.” Epidemiologists at work…
Notas del editor
- Specimen i Hektoen Enteric Agar (HE) is a selective and differential medium designed to isolate and differentiate members of the species Salmonella and Shigella from other Enterobacteriaceae . Bile salts and the dyes bromthymol blue and acid fuchsin inhibit the growth of most Gram positive organisms. Lactose, sucrose, and salicin provide fermentable carbohydrates to encourage the growth and differentiation of enterics. Sodium thiosulfate provides a source of sulfur. Ferric ammonium citrate provides a source of iron to allow production of hydrogen sulfide from sodium thiosulfate, which provides a source of sulfur. Ferric ammonium citrate also allows the visualization of hydrogen sulfide production by reacting with hydrogen sulfide gas to form a black precipitate. Enterics that ferment one or more of the carbohydrates will produce yellow to salmon-colored colonies. Non-fermenters will produce blue-green colonies. Organisms that reduce sulfur to hydrogen sulfide will produce black colonies or blue-green colonies with a black center.
- In 2/3 of outbreaks with no identified etiology, no stool specimens are submitted for testing