Staphylococcus & Staphylococcal food poisoning

What is Staphylococcus?

1) Staphylococcus aureus is a common bacterium found on the skin and in the noses of up to
25% of healthy people and animals.
2) Staphylococcus aureus is important because it has the ability to make seven different toxins
that are frequently responsible for food poisoning.

What is staphylococcal food poisoning?

1) Staphylococcal food poisoning is a gastrointestinal illness. It is caused by eating foods

contaminated with toxins produced by Staphylococcus aureus .
2) The most common way for food to be contaminated with Staphylococcus is through contact
with food workers who carry the bacteria or through contaminated milk and cheeses.
Staphylococcus is salt tolerant and can grow in salty foods like ham.
3) As the germ multiplies in food, it produces toxins that can cause illness.
4) Staphylococcal toxins are resistant to heat and cannot be destroyed by cooking.
5) Foods at highest risk of contamination with Staphylococcus aureus and subsequent toxin
production are those that are made by hand and require no cooking.
6) Some examples of foods that have caused staphylococcal food poisoning are sliced meat,
puddings, some pastries and sandwiches.

What are the symptoms of staphylococcal food poisoning?

1) Staphylococcal toxins are fast acting, sometimes causing illness in as little as 30 minutes.
Symptoms usually develop within one to six hours after eating contaminated food.
2) Patients typically experience several of the following: nausea, vomiting, stomach cramps, and
diarrhea. The illness is usually mild and most patients recover after one to three days. In a
small minority of patients the illness may be more severe.

How should a patient with suspected staphylococcal food poisoning be treated?

1) For most patients, staphylococcal food poisoning will cause a brief illness.
2) The best treatments for these patients are rest, plenty of fluids, and medicines to calm their
stomachs
3) Antibiotics are not useful in treating this illness. The toxin is not affected by antibiotics.

Is a sick patient infectious?

1) Patients with this illness are not contagious. Toxins are not transmitted from one person to
another.

How can staphylococcal food poisoning be prevented?

It is important to prevent the contamination of food with Staphylococcus before the toxin can be
produced.

Wash hands and under fingernails vigorously with soap and water before handling and
preparing food.
Do not prepare food if you have a nose or eye infection.
Do not prepare or serve food for others if you have wounds or skin infections on your hands or
wrists.
Keep kitchens and food-serving areas clean and sanitized.
If food is to be stored longer than two hours, keep hot foods hot (over 140°F) and cold foods
cold (40°F or under).
Store cooked food in a wide, shallow container and refrigerate as soon as possible.
 Vibrio cholerae & Cholera

What is Cholera?
1) Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium
Vibrio cholerae.
2) An estimated 3-5 million cases and over 100,000 deaths occur each year around the world.
The infection is often mild or without symptoms, but can sometimes be severe. Approximately
one in 20 (5%) infected persons will have severe disease characterized by profuse watery
diarrhea, vomiting, and leg cramps.
3) In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment,
death can occur within hours.
Where is Cholera Found?
1) The cholera bacterium is usually found in water or food sources that have been contaminated
by feces (poop) from a person infected with cholera.
2) Cholera is most likely to be found and spread in places with inadequate water treatment, poor
sanitation, and inadequate hygiene.
3) The cholera bacterium may also live in the environment in brackish rivers and coastal waters.
Shellfish eaten raw have been a source of cholera.
How Does a Person Get Cholera?
1) A person can get cholera by drinking water or eating food contaminated with the cholera
bacterium.
2) In an epidemic, the source of the contamination is usually the feces of an infected person that
contaminates water and/or food.
3) The disease can spread rapidly in areas with inadequate treatment of sewage and drinking
water.
4) The disease is not likely to spread directly from one person to another; therefore, casual
contact with an infected person is not a risk for becoming ill.
What are the Symptoms of Cholera?
1) Cholera infection is often mild or without symptoms, but can sometimes be severe.
Approximately one in 20 (5%) infected persons will have severe disease characterized by
profuse watery diarrhea, vomiting, and leg cramps.
2) In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment,
death can occur within hours.
How Long After Infection Do the Symptoms Appear?
1) It can take anywhere from a few hours to 5 days for symptoms to appear after infection.
Symptoms typically appear in 2-3 days.
Who is most likely to Get Cholera?
1) Individuals living in places with inadequate water treatment, poor sanitation, and inadequate
hygiene are at a greater risk for cholera.
What Should I Do If I Think I Have Cholera?
1) If you think you may have cholera, seek medical attention immediately. Dehydration can be
rapid so fluid replacement is essential.
What is the Treatment for Cholera?
1) Cholera can be simply and successfully treated by immediate replacement of the fluid and salts
lost through diarrhea.
2) Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and
salts to be mixed with water and drunk in large amounts.
3) This solution is used throughout the world to treat diarrhea. Severe cases also require
intravenous fluid replacement.
4) With prompt rehydration, fewer than 1% of cholera patients die. Antibiotics shorten the course
and diminish the severity of the illness, but they are not as important as receiving rehydration.
5) Persons who develop severe diarrhea and vomiting in countries where cholera occurs should
seek medical attention promptly.
Should I Be Worried About Getting Cholera From Others?

1) The disease is not likely to spread directly from one person to another; therefore, casual
contact with an infected person is not a risk for becoming ill.

How Can I Avoid Getting Cholera?

1) The risk for cholera is very low for people visiting areas with epidemic cholera. When
simple precautions are observed, contracting the disease is unlikely.
2) All people (visitors or residents) in areas where cholera is occurring or has occurred should
observe the following recommendations:
 Drink only bottled, boiled, or chemically treated water and bottled or canned
carbonated beverages. When using bottled drinks, make sure that the seal has not
been broken.
o To disinfect your own water: boil for 1 minute or filter the water and add 2
drops of household bleach or ½ an iodine tablet per liter of water.
o Avoid tap water, fountain drinks, and ice cubes.
 Wash your hands often with soap and clean water.
 If no water and soap are available, use an alcohol-based hand cleaner (with at least
60% alcohol).
o Clean your hands especially before you eat or prepare food and after using the
bathroom.
 Use bottled, boiled, or chemically treated water to wash dishes, brush your teeth, wash
and prepare food, or make ice.
 Eat foods that are packaged or that are freshly cooked and served hot.
o Do not eat raw and undercooked meats and seafood or unpeeled fruits and
vegetables.
 Dispose of feces in a sanitary manner to prevent contamination of water and food
sources
 Clostridium botulinum & Botulism
What is botulism?

1) Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by
the bacterium Clostridium botulinum.

2) There are five main kinds of botulism. Foodborne botulism is caused by eating foods that
contain the botulinum toxin.

3) Wound botulism is caused by toxin produced from a wound infected with Clostridium
botulinum. Infant botulism is caused by consuming the spores of the botulinum bacteria,
which then grow in the intestines and release toxin.

4) All forms of botulism can be fatal and are considered medical emergencies. Foodborne
botulism is a public health emergency because many people can be poisoned by eating a
contaminated food.

What kind of germ is Clostridium botulinum ?

1) Clostridium botulinum is the name of a group of bacteria.
2) They can be found in soil. These rod-shaped organisms grow best in low oxygen conditions.
3) The bacteria form spores which allow them to survive in a dormant state until exposed to
conditions that can support their growth.
4) There are seven types of botulism toxin designated by the letters A through G; only types A,
B, E and F cause illness in humans.
What are the symptoms of botulism?
1) The classic symptoms of botulism include double vision, blurred vision, drooping eyelids,
slurred speech, difficulty swallowing, dry mouth, and muscle weakness.
2) Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and
poor muscle tone.
3) These are all symptoms of the muscle paralysis caused by the bacterial toxin. If untreated,
these symptoms may progress to cause paralysis of the respiratory muscles, arms, legs, and
trunk. In foodborne botulism.
4) Symptoms generally begin 18 to 36 hours after eating a contaminated food, but they can
occur as early as 6 hours or as late as 10 days.
How can botulism be treated?
1) The respiratory failure and paralysis that occur with severe botulism may require a patient to
be on a breathing machine (ventilator) for weeks or months, plus intensive medical and
nursing care.
2) The paralysis slowly improves. Botulism can be treated with an antitoxin which blocks the
action of toxin circulating in the blood.
Are there complications from botulism?

1) Botulism can result in death due to respiratory failure. However, in the past 50 years the
proportion of patients with botulism who die has fallen from about 50% to 3-5%.

2) A patient with severe botulism may require a breathing machine as well as intensive medical
and nursing care for several months, and some patients die from infections or other problems
related to remaining paralyzed for weeks or months.

3) Patients who survive an episode of botulism poisoning may have fatigue and shortness of
breath for years and long-term therapy may be needed to aid recovery.

How can botulism be prevented?

1) Foodborne botulism has often been from home-canned foods with low acid content, such as
asparagus, green beans, beets and corn and is caused by failure to follow proper canning
methods.

2) Persons who do home canning should follow strict hygienic procedures to reduce
contamination of foods, and carefully follow instructions on safe home canning including the
use of pressure canners/cookers as recommended.

3) Oils infused with garlic or herbs should be refrigerated. Potatoes which have been baked while
wrapped in aluminum foil should be kept hot until served or refrigerated.

4) Because the botulinum toxin is destroyed by high temperatures, persons who eat home-
canned foods should consider boiling the food for 10 minutes before eating it to ensure safety.

5) Wound botulism can be prevented by promptly seeking medical care for infected wounds and
by not using injectable street drugs. Most infant botulism cases cannot be prevented because
the bacteria that causes this disease is in soil and dust.

6) Honey can contain the bacteria that causes infant botulism so, children less than 12 months
old should not be fed honey. Honey is safe for persons 1 year of age and older.