Food Sanitation

FCM 3 Food Sanitation Rosa Marie N. Flores, MD 4th/December 17, 2008 Manzano and Manzano FOODBORNE ILLNESSES • Marie Jeanne Beltran-Berroya • January 1, 2005 • / 20 • Aling Carina was experiencing bouts of diarrhea and muscle cramps, this was her fourth time entering the toilet. Her head was throbbing with pain, she has fever and was vomiting. What might have caused all these symptoms? Suddenly she thought of the foods she ate that may have caused these symptoms. What are Foodborne Illnesses?____________________ • Foodborne illnesses are on the rise globally. Food borne illnesses are diseases either infectious or toxic in nature caused by ingesting pathogens (e.g. bacteria, fungi, parasites, viruses) through contaminated food or water. The condition is otherwise known as food poisoning. Magnitude of Foodborne Illnesses_________________ • Foodborne illnesses are a growing health problem in developed and developing countries. It was reported that in 2000 alone, 2.1 million people died of diarrheal disease worldwide. • Some well recognized foodborne illness are recognized as emerging because recently these foodborne illnesses are becoming more common, e.g. salmonellosis. Salmonellosis has been reported decades ago but has now increased in incidences in many countries worldwide. • In developed countries like the United States, there are 76 million cases of foodborne illnesses every year, 2 million cases in the United Kingdom, one million cases in Canada and 750,000 cases in France. • The Food and Agriculture Organization statistics show that every year 700,000 people die from food and water borne disease in the Asia-Pacific region including the Philippines. • Most foodborne illnesses are sporadic and often not reported thus less documented. There are no available statistics for foodborne illnesses of developing countries. • The World Health Organization announced that in the Asia-Pacific region, the danger of food related outbreaks is acute due to the proximity of animal and people to food production and food distribution that are unsafe. • Foodborne illnesses are costly. In the United States for example, health experts estimated the yearly costs of foodborne illnesses at $6 billion in medical costs and loss in productivity. For salmonellosis alone, the cost is $1 Billion/year. Why do Foodborne Illnesses occur?________________

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Most common causes of foodborne illness are errors on food handling and preparation at home, in restaurants and other eatingplaces. People busy working turn to convenience due to lack of time. They resort to buying prepared or cooked foods instead of handling and preparing their own thus resulting to high incidences of health hazards.

What are the risk factors for Foodborne Illnesses?____ • Young children, pregnant mothers, the elderly and the immuno-compromised are at greater risks of foodborne illnessses due to age and their immune status. What are the symptoms of Foodborne Illnesses?_____ • Individuals infected with foodborne organisms may have no symptoms or may develop symptoms ranging from headaches, dizziness, fever, vomiting, diarrhea, stomach upset, muscle aching to severe cramps and dehydration. The onset of the symptoms may not occur at once but in two days or more after the contaminated food was ingested. What are the common Illnesses?_______ • harmful bacteria, • moulds, • parasites and viruses.

causes

Foodborne

Some of the common food pathogens that are responsible for the majority of reported cases of foodborne illness are: • Escherichia coli, • Campylobacter jejuni, • Listeria, • Salmonella, • Shigella, • Vibrio cholerae, • Hepatitis A, • Entamoeba histolytica and • Norwalk viruses. Escherichia Coli 0157:H7 became known to the public because of an outbreak caused by contaminated hamburgers. E. coli 0157:H7 infection causes severe bloody diarrhea and abdominal cramps, with little or no fever. It can result to hemorrhagic colitis and causes hemolytic uremic syndrome in children. Incubation period is from 3 to 5 days. Outbreak cases have been associated to foods like hamburger, un-pasteurized milk, juice, lettuce, salami, sprouts and cantaloupe.

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raw vegetables, milk and dairy products, and poultry.

S. typhimurium and S. enteriditis are the two leading causes of salmonellosis. Salmonella bacteria live in the intestinal tracts of domestic and wild animals and may contaminate raw meat, poultry, eggs, dairy products and other foods. S. typhimurium is only carried by humans that causes typhoid fever and is characterized by fever, diarrhea and inflammation of the infected organs. S. enteriditis is egg-associated salmonellosis. It is characterized by fever, nausea, abdominal cramps and diarrhea beginning 12 to 72 hours after consuming the contaminated food or beverage. The illness can last 4 to 7 days. Listeria monocytogenes is a gram-positive bacterium and it is hardy, resists freezing, drying and heat. Listeria is associated with foods like raw milk, soft or semi-soft cheeses, ice cream, raw vegetables, meat, poultry, raw and smoked fish. Listeria can grow at refrigerated temperature. Incubation period for Listeriosis is 4 days to several weeks and it can cause meningitis and spontaneous abortion. Listeria monocytogenes has a fatality rate of 30%. Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Symptoms of diarrhea, cramping, abdominal pain, fever and vomiting usually occur two to five days after ingestion of the contaminated food or water. The diarrhea may be bloody and the illness typically lasts one week. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious lifethreatening infection. Incubation period is from 2 to 5 days. The consumption of undercooked poultry and cross-contamination of other foods with drippings from raw poultry are the leading risk factors for human campylobacteriosis. Larger outbreaks due to Campylobacter are not usually associated with raw poultry but are usually related to drinking un-pasteurized milk or contaminated water. Shigellosis or bacillary dysentery is an infectious disease caused by the bacteria Shigella. The most common symptoms are bloody diarrhea, fever, nausea, vomiting and cramps. Shigellosis usually resolves in 5 to 7 days. Outbreaks of shigellosis occur frequently where there is overcrowding and poor sanitation and where personal hygiene is poor. Shigella organisms are transmitted via the fecal-oral route. The most common cause of contamination is unsanitary handling by food handlers and water contaminated with human waste. Vegetables are sources of contaminated if they are harvested from a field with sewage in it. Foods associated with shigella are salads (potato, tuna, shrimp, macaroni, and chicken),

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Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. The disease is characterized by profuse watery stools, vomiting and leg cramps. The incubation period for vibrio cholerae is 24 to 48 hours. The rapid loss of body fluids leads to dehydration and shock and if left untreated may cause death. The cause of contamination is water, fish, shellfish and street foods that are un-hygienically prepared.

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Entamoeba histolytica is the parasite causing inflammation of the intestine called amoebiasis or amoebic dysentery. The symptoms include bloody diarrhea, nausea, stomach cramps, vomiting, loss of appetite, and fatigue. Symptoms appear from 2-3 days to 1-4 weeks. Foods associated with the disease are water, any uncooked foods or foods contaminated by an ill food handler.

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Hepatitis A, the most common of hepatitis is transmitted through person-to-person contact when a person does not wash his hands properly after toilet use. Common sources of outbreaks have been related to water contamination, food contamination by infected food handlers and raw or undercooked shellfish from contaminated waters. The symptoms are fever, fatigue, loss of appetite, nausea, abdominal discomfort, jaundice, dark urine and joint aches. The symptoms occur within 15 � 50 days within exposure.

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Norwalk and Norwalk-like viruses are transmitted through the fecal-oral route via contaminated water and foods. Water is the most common source of the outbreaks while shellfish and salad ingredients are the common implicated foods although any food can be contaminated with the virus by an infected person. The symptoms of the illness occur within 24-48 hours after water or food has been ingested. Symptoms are nausea, vomiting, diarrhea, abdominal cramps, fever, headache and muscle pains.

Why do Foodborne Illnesses emerge?______________  Globalization of the food supply  increase in international travel and trade  Changes in micro-organisms, i.e. evolution of new pathogens, changes in the ability to survive in various environmental conditions, development of new virulent strains from old pathogens, development of resistance to drugs making the treatment of the disease difficult  Changes in the food production system

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Changes in lifestyles of the human population

How do we treat Foodborne Illnesses?______________

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Mild cases of foodborne illness can be treated by increased fluid intake to replace fluid and electrolyte losses while severe cases need hospitalization for medical and nutritional therapy.

How do we prevent Foodborne Illnesses?___________ • Careful washing of hands before preparing food, thorough cooking of foods particularly beef, poultry and eggs, thorough washing of fruits and vegetables especially those that will be eaten raw, avoid drinking un-pasteurized milk, fruit juices and untreated surface water and protecting foods from insects, animals and rodents.  To prevent harmful bacteria from growing in foods: o Refrigerate foods immediately. o Cook foods to proper temperature. Properly cooked foods are heated long and at high temperature to kill the harmful bacteria. o Prevent cross contamination (e.g. separate raw foods from cooked foods). o Handle foods properly. Conclusion____________________________________ • Food safety is an increasingly important public health issue as there is an alarming increase in foodborne outbreaks. • Foodborne illnesses continue to have major impact on the health of individuals. Microorganisms continue to adapt and evolve, increasing their virulence. The foodborne illness, E. coli 0157:H7 was unrecognized as a foodborne disease two decades ago. • Bacteria recognized as sources of foodborne illnesses have found new modes of transmission. For example, Salmonella enteritidis, which only contaminated the outside shell of eggs, is now also found inside many eggs, making uncooked eggs no longer safe to eat. Foodborne illness is costly in terms of direct medical expenses and loss in productivity. • Aggressive research efforts must be done to identify, assess and control microbiological hazards associated with food production from farm to table. Intensified focus on education to all food handlers and consumers about safe food handling must be a priority. Reinforcing hygienic practices at each link in the food chain, from producer to consumer is critical in preventing these foodborne diseases.