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Lecture Objectives

Introduction to Food Safety

Describe in detail the bacterial pathogens which contaminate food in the
United States (continued from Lecture 6).

Lecture 7
Bacterial Food Pathogens Part II
Identify the food groups and route of spread usually associated with these
bacterial pathogens.
Determine the diseases which result from these pathogens.
Discuss control and prevention.

Salmonella Salmonella (continued)

Disease symptoms include: Salmonella is one of the most Raw poultry

Nausea common foodborne pathogens Raw meats
Diarrhea and has been linked to a large
Vomiting number of food groups, including Eggs
Abdominal cramps those shown on the right. Milk
Fever
Salmonella can be spread to Dairy products
2nd leading cause of foodborne humans via feces from animals or
illness (11% overall). Complex foods
other humans.
Complex foods are those items that
Leading cause of foodborne include more than one food type.
hospitalization (35% overall). For example a smoothie is complex
Leading cause of foodborne as it includes both dairy and fruit.
deaths (28% overall).

Despite the quote on the CDC webpage that

it is illegal to sell small turtles (left), one quick
Google search turns up a seller (below).
Source: CDC.gov

Contact with live birds can occur at live

bird markets (top right) and at petting
zoos (bottom right).

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Impact of Salmonella Food Poisoning

More than 42,000 cases of

Salmonellosis are reported to the
CDC annually.
Approximately 400 people die
annually in the US of Salmonella.
Young children
Elderly
In 2007, a three week old Immunocompromised
baby died of Salmonella in
North Central Florida after
coming in contact with a
baby turtle illegally sold at
a flea market. Less than 1 year after the massive Listeria-cantaloupe outbreak,
we have another cantaloupe outbreak involving Salmonella
which killed 3 people.

Salmonella Common Source Outbreak - CDC

Salmonella
Outbreaks
Salmonella outbreaks occur
annually as shown here for Reminder: Salmonella in a mass produced product like peanut butter can spread
2013 and 2014 (as of Jan 2015)
throughout the entire nation.

Salmonella in Peanut Butter Salmonella (continued)

Salmonella was introduced into Treatment: self-limiting, may

peanut butter on the production require rehydration.
line, causing the outbreak shown Despite the fact that Salmonella
on the previous slide and does not have to be treated,
discussed in Lecture 5. greater than 50% of all of those
Water from the roof (which persons who are infected do get
contained feces from birds) was treatment, resulting in antibiotic
dripping into the jars BEFORE resistant strains.
they were filled with the peanut
butter.
Source: LATimes.com
Source: Caf Press

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Salmonella (continued)
Prevention of Salmonella is
complicated and related to the
food group.
Meats proper cooking
Dairy pasteurization
Eggs 1% of all eggs are
contaminated and the only
prevention is proper cooking.
Produce proper washing, but
tomatoes and sprouts may be
internally contaminated.
Salmonella Typhi
Causative agent of typhoid fever which
is systemic disease with 10% case
fatality rate.
Transmitted by contaminated food and
water.
Usually spread by carriers who have
bad hand hygiene do not wash hands
after using bathroom and before
preparing foods (Typhoid Mary).
Disease usually does not occur in the
United States but infected person may
travel to the US and contaminated
foods are sometimes imported.
Shigella (Bacillary Dysentery)
Symptoms: diarrhea (containing
blood and mucus), abdominal pain,
fever.
Note: anytime blood is found in the
stool it is referred to as dysentery.
Shigella has a VERY low infectious
dose and can be spread by flies.
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Studies have shown that
Salmonella may enter the roots of
tomatoes and possibly lettuce and
contaminate the produce from the
inside.
Similarly, the seeds of sprouts may
contain Salmonella which then
infects the crop when it is
germinated.
A number of graphics are available to combat food
poisoning due to Salmonella. Because they are often
the victims, many of the graphics are aimed at kids.
Salmonella Typhi (continued)
Prevention involves the use of the
vaccine which is recommended
for anyone traveling to an
endemic area.
Treatment: ceftriaxone and
cefoperazone
Shigella (continued)
Spread is fecal-oral, usually in raw
milk or water but other foods
have also been implicated.
Treatment: Bactrim, occasionally
fluid replacement.
Olympic Fountain Atlanta, interactive fountains
such as this one can spread Shigella if they are not
chlorinated.
Source: Maricopa.gov
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A Note on Shigella
Shigella
Foodborne Because of its low infectious
dose, Shigella is often spread in
Outbreak daycares.
47 confirmed cases, 116 The spread is fecal-oral which is
probable cases. one reason why quality daycares
12 flights implicated. regularly wash the childrens
Raw carrots spread the hands, changing tables, toys, etc.
disease.
Global spread of pathogen.

Staphylococcus aureus Staphylococcus aureus

Intoxication is caused by ingestion of Foods affected include dairy

food containing staphylococcal
enterotoxins.
Only certain strains of S. aureus
produce foodborne enterotoxins.
Staphylococcus is normal flora of the
skin and food is usually contaminated
by the person who is preparing the
dish.
Improper holding temperatures aids
microbial growth and toxin formation.
Nausea, vomiting, diarrhea are
symptoms.
products, cream-filled pastries,
custards, ham, sausage, mayo-
containing foods.
There is no treatment, the toxin
induces vomiting which rids the
body of the poison.
Note: SEB (Staphylococcal
enterotoxin B) is a select agent Staphylococcus toxins are often found in foods which
and could potentially be used for
have been held at incorrect temperatures such as
potato salad left in the sun.
bioterrorism.
This guy made national news for mishandling
foods and was fired.

Streptococcus spp. Group A

Includes Streptococcus pyogenes,

the organism that causes strep
sore throat.
Disease is know as pharyngitis or
more commonly, sore throat.
Food becomes infected from the
food handler.
Poor personal hygiene Rapid Strep kit works well to detect the pathogen
from a patient, does not detect it in foods.

The food preparer was probably the source of the Staphylococcus in this outbreak.
The handling of the food indicates serious temperature abuse issues.

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Streptococcus spp. Group A

Although usually considered a mild

infection, untreated S. pyogenes
infections can cause scarlet fever and
rheumatic fever (which can destroy
heart tissue).
Most of the flesh-eating bacteria
are S. pyogenes strains.
Streptococcal infections are treated
with a large number of antibiotics.
Pasta was the likely
Prevention includes the use of gloves source of this outbreak.
to prevent spread from wounds and Streptococcus pyogenes demonstrating how the organism An outbreak which
proper food preparation. with a potent toxin can quickly destroy tissue.
might have been missed
if not for Facebook!

Vibrio cholerae Vibrio cholerae (continued)

Sudden onset vomiting, profuse Spread by fecal/oral route,

watery diarrhea, and rapid contaminated water and seafood,
dehydration (15% body weight
can be lost). vegetables.
Often the contaminated water is
V. cholerae causes such rapid used to prepare foods in turn
fluid loss that patients are often
treated on tables with a hole cut contaminating the foods.
in the middle for diarrhea to fall Rx: fluid electrolyte replacement.
into a bucket (cholera cots) ORS or oral rehydration salts are the
while IV hydration is treatment of choice but they must
administered (picture at right).
be made with clean water.
V. cholerae is uncommon in the
United States but has been
found in seafood from the Gulf
of Mexico.

Vibrio cholera John Snow Vibrio cholera - Haiti

John Snow is considered the 10 months after the catastrophic

father of epidemiology for his earthquake hit Haiti in 2010, the
study of the spread of cholera in country was hit with a massive
London. outbreak of cholera:
The outbreak was caused by 670,000 cases
feces-contaminated water. Over 8000 attributable deaths
In other words, this was large It is believed that cholera was
common source outbreak. brought to Haiti by international
Cholera cases were marked on a map to track the source of the aid workers (see next slide).
disease to a water pump on Broad street.
As many as 85,000 people may have died from the earthquake,
millions were displaced.

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Vibrio vulnificus
V. vulnificus are naturally found in
several waterways including the
Gulf of Mexico.
Contaminate any seafood found in
that area.
Foodborne V. vulnificus can cause
diarrhea, abdominal cramps,
nausea, vomiting, headache,
fever, and chills.
Vibrio vulnificus
Although V. vulnificus infections
are rare compared to the other
bacterial pathogens discussed,
the CFR (case fatality rate) is 50%.
Please note: the claim in the paper
that this CFR is the highest of any
foodborne pathogen is not correct,
that distinction belongs to the
prions (mad cow disease).
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Cholera cases often follow natural disasters. Especially where water and sewage systems
have been disrupted.
Vibrio vulnificus (continued)
Prevention of disease requires
restrictions on fishing in
contaminated waterways and
cooking of seafood.
Antibiotics may be used for
treatment.
Oyster harvest areas had to be closed after the gulf oil spill.
Reports claim to have found high levels of Vibrio within oil tar.
Vibrio parahaemolyticus
Produces explosive watery
diarrhea.
Ingestion of raw oysters,
improperly cooked crab,
shrimp, clams, and scallops.
Common in Florida
Treatment includes fluids,
electrolyte replacement.
Oyster harvesting
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Vibrio species
Additional Vibrio species can
cause human disease via food.
Symptoms will be similar to what
is reported on the previous slides
for other Vibrio species.
Treatment depends on mode of
disease:
Toxin = rehydration
Infection = antibiotics.
Yersinia
enterocolitica
In 2011, Y. enterocolitica
caused an outbreak of illness
linked to pasteurized milk.
Despite environmental
sampling, the source of the
bacterium was never found.
The dairy was allowed to
reopen and no further cases
were reported.
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Yersinia enterocolitica
Spread in undercooked pork and in raw
milk.
Two types of disease:
self-limiting diarrhea
abrupt onset nausea, cramps, vomiting, and
diarrhea.
Rx: fluid and electrolyte replacement in
severe cases.
Some squid harbor Vibrio fischeri near their eyes, and this
Prevention:
bacteria produces light (bioluminescence). ecosystm.org cooking for pork
pasteurization for milk.
Lecture 7 - Summary
Bacterial pathogens commonly cause disease in meats, produce, dairy, and
water.
Disease can range from mild diarrhea to debilitating conditions and death.
The common causes of foodborne contamination are time and temperature
abuse, poor personal hygiene, and cross contamination and understanding
these causes are key to preventing these diseases.