Characteristics of Foodborne Illness Due to Infectious Agents - 2000

--------------------------------- Agent Pathogenesis --------------------------------- BACTERIAL AGENTS Bacillus Enterotoxin produced cereus in food or in intestine Helicobacter Invasion of large and jejuni small intestine Clostridium Neurotoxin produced botulinum in food Clostridium Cytotoxin and difficile enterotoxin produced in large intestine secondary to overgrowth Clostridium Enterotoxin released perfringens during sporulation in large intestine E coli Entero- Enterotoxin produced toxigenic in small intestine Invasive Invasion of large intestinal mucosa Adherent Adheres tightly to small bowel mucosa Hemorrhagic Verotoxin produced in (e.g. type large bowel o157:47) Salmonella Invasion of small and spp. large intestine Salmonella Invasion of small typhi intestine mucosa, systemic dissemination Shigella Invasion of large spp. intestine Staph Enterotoxin produced aureus in food Streptococcus Invasion of upper group A respiratory tract Vibrio Enterotoxin produced cholerae in small intestine Vibrio Probably both parahaemo- invasion and lyticus enterotoxin Vibrio Mechanism unknown vulificus Yersinia Invasion of small and entero- large intestine colitica VIRAL AGENTS Parvovirus Invasion of small -like agents intestine (Norwalk) Rotavirus Invasion of small intestine PROTOZOA AND HEILMINTHS Entamoeba Invasion of large histoiytica intestine Giardia Colonization and lamblia occasional invasion of small intestine Trichinella a) Encysted trichinae spirafis mature, mate, reproduce in small intestine; (b) larvae penetrate intestine, migrate to muscles Crypto- Colonization sporidia ---------------------------------

Comparison of Symptoms --------------------------------- Symptom Rotavirus --------------------------------- Nausea 2% 85% Vomiting 9% 84% Abd cramps 26% 62% Diarrhea 33% 44% Fever 5% 32% Headache - 37% ---------------------------------

Return Home Page ------------------------------------------------------------------------------------ Usual Clinical Features Reservoir Transmission Incubation Period ------------------------------------------------------------------------------------ Vomiting if preformed Soil Foodborne 2-16 hr toxin in food, diarrhea Fever, abdominal pain, Animal feces Foodborne or 24-48 hr diarrhea waterborne Vomiting, diarrhea, Animal feces, Foodborne 12-36 hr symmetric motor soil (canned, paralysis, cranial low pH, nerves, death anaerobic) Fever, abdominal pain, Ubiquitous, unnecessary 1-10 days after diarrhea (often especially in may occur in beginning bloody) in a patient healthcare hospitals antibiotics currently or recently environments on antibiotics (spores) Diarrhea, occasionally Human feces, Foodborne 12-24 hr vomiting animal feces, (meats) soil Voluminous watery Human feces Foodborne 24-48 hr diarrhea Fever, dianhea (often Human feces Foodborne 24-48 hr bloody) (cheeses) Acute diarrhea, which Human feces Probably 24-48 hr may be prolonged foodborne Hemorrhagic colitis, Animal feces Foodborne 24-48 hr may be followed by hemolytic uremic synd. Fever and diarrhea Animal feces; Foodborne 12-48 hr eggs (many foods) person-to- person Protracted illness: Human feces Person-to- 4 days-3 weeks fever, malaise, person, headache, foodborne constipation more often than diarrhea, splenornegally, occasionally intestinal perf. Fever, diarrhea (often Human feces Person-to- 12-48 hr bloody) person Vomiting dominates, Human skin, Foodborne 2-8 hr diarrhea nares, mouth (many foods) Streptococcal Human pharynx, Foodborne 1-3 days pharyngitis skin lesions Voluminous watery Human feces Waterborne and 12 hr-5 days diarrhea without foodborne fever Diarrhea, abdominal Seawater Foodborne 15-24 hr cramps (various types of seafood) Fever, abdominal pain, Seawater Foodborne 24 hr-2 days diarrhea; septicemia (various seafood) cutaneous lesions Fever, abdominal pain, Animal feces Foodborne, Probably 3-7 may suggest person-to- days appendicitis, person diarrhea Vomiting and diarrhea Human feces Food-and 1-3 days waterborne, person-to- person Severe gastroenteritis Human feces Person-to- 1-3 days in young children, person mild in adults Diarrhea, often Human feces Food-and Few days to chronic and bloody waterborne, months person-to- person' Diarrhea, flatulence Human feces Waterborne, 1-4 weeks with foul-selling person-to- stools person' Diarrhea, puffy eyes, Animal muscle Foodborne 2-28 days muscle aching, (swine, many fever, occasionally wild animals) severe heart failure; eosinophilia typical Diarrhea, acute in Human and Probably 2-7 days children and healthy animal feces animal to adults; chronic in person HIV-Infected patients ------------------------------------------------------------------------------------ of Gastroenteritis in Adults

---------------------------------- Norwalk Salmonella shigella S. aureus ---------------------------------- 50% 45% 62% 23% 39% 86% 78% 60% 86% 73% 100% 67% 49% 72% 10% 33% 6% var. ---------------------------------- to The Intern in the Middle of the Night

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