Food Poisoning or Foodborne Illness

Basics

Basics

Basics

Description

Description

Description

Any illness resulting from the ingestion of food or drink contaminated with an infectious organism or associated toxin

Epidemiology

Epidemiology

Epidemiology

  • Highest incidence in children <5 years
  • Hospitalizations and death more common in persons >64 years
  • See Appendix, Table 8 regarding epidemiologic aspects by organism.

General Prevention

General Prevention

General Prevention

  • Vaccination
    • Oral rotavirus vaccine
    • Hepatitis A vaccine
  • Preventive strategies
    • Hand washing (soap and water)
    • Avoidance of contaminated water and raw foods (seeded fruits and vegetables)
    • Proper food handling (adequate cooking and refrigeration)
    • Avoidance of unpasteurized dairy products and juices
    • Avoidance of raw or undercooked eggs, meat, and shellfish
    • Avoidance of honey in children <1 year old

Pathophysiology

Pathophysiology

Pathophysiology

  • Gastroenteritis
    • Viral epithelial invasion/replication or ingestion of preformed elaborated toxin
  • Noninflammatory diarrhea
    • Selective destruction of absorptive cells in mucosa, leaving secretory cells intact
    • Toxin elaboration (secretory diarrhea)
    • Impairment of brush border enzymes and lactose intolerance (osmotic diarrhea)
  • Inflammatory diarrhea/dysentery
    • Direct mucosal invasion of intestinal epithelial cells (colon)
    • Toxin elaboration
    • Inflammatory infiltration destroys villous cells and transporters and leads to exudation of mucus/protein/blood into gut.
  • Local/remote invasion (bacteremia, meningitis, hepatitis, septic arthritis, osteomyelitis)
  • Immune-mediated extraintestinal manifestations (hemolytic uremic syndrome (HUS), reactive arthritis, Guillain-Barré syndrome [GBS])

Etiology

Etiology

Etiology

  • Viruses
    • Most common cause of foodborne illness
    • Caliciviruses (norovirus, sapovirus)
    • Rotavirus (infant/child)
    • Astrovirus
    • Enteric adenovirus
    • Hepatitis A
  • Bacteria
    • Salmonella typhi, Salmonella paratyphi, nontyphoidal Salmonella
    • Campylobacter jejuni, Campylobacter coli
    • Shigella sonnei, Shigella flexneri, Shigella boydii
    • Escherichia coli
      • Enterohemorrhagic E. coli (EHEC) including Shiga toxin–producing E. coli (STEC)
      • Enteropathogenic E. coli (EPEC)
      • Enterotoxigenic E. coli (ETEC)
      • Enteroinvasive E. coli (EIEC)
      • Enteroaggregative E. coli (EAEC)
    • Vibrio cholerae, Vibrio parahaemolyticus, Vibrio vulnificus
    • Listeria monocytogenes
    • Brucella spp.
    • Yersinia enterocolitica
  • Toxin mediated
    • Clostridium perfringens
    • Staphylococcus aureus
    • Bacillus cereus
    • Clostridium botulinum
  • Parasites
    • Entamoeba histolytica
    • Giardia intestinalis
    • Cryptosporidium
    • Cyclospora cayetanensis
    • Toxoplasma gondii
    • Trichinella spiralis

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