FOODBORNE DISEASES

Name Characteristics Pathogenesis Source Symptoms Other

Botulinum toxin (heat-
labile neurotoxin).
Inhibits release of ACh at
Clostridium NMJ, flaccid paralysis
botulinum
- Tx: Botulinum-specific
antitoxin (hyperimmune
5 D’s: Dysarthria, globulin)
Improperly canned - Can affect infants:
Dysphagia,
foods, food not “floppy baby” (raw honey)
Dysphonia, Diplopia,
sufficiently heated
Descending paralysis

Heat-labile pore-forming
enterotoxin, damages
 Gram (+) bacilli brush border in SI, alters
 Catalase (-) cell membrane
Clostridium  Endospores permeability, loss of fluid Reheated meats,
Watery diarrhea
perfringens  Anaerobic gravy dishes
 -hemolytic
 Motile

Toxin A: enterotoxin. MCC of nosocomial

Toxin B: cytotoxin. diarrhea
Hypervirulent strains - Dx: EIA for glutamate
dehydrogenase (GDH) or
Clostridium Recent antibiotic Watery diarrhea EIA for toxins- specific
difficile exposure severe: bloody diarrhea
- Tx: discontinue antibiotics

Enterotoxin (SEA),
superantigen (stimulates
 Gram (+) rod
vomiting)
 Catalase (+)
Staphylococcus Salty, high fat foods Watery diarrhea,
 Facultative an.
(mayo, ham), hard nausea, vomiting, abd
aureus  Coagulase (+)
boiled eggs pain
 Yellow colonies
(mannitol salt agar)

Emetic Form:
Cerulide (enterotoxin),
binds serotonin receptors of
CN X Vomiting Short incubation

 Catalase (+)
 -hemolytic Fried rice dishes,
Bacillus cereus  Endospores Diarrheal Form: starchy foods, meats
 Aerobic vegetative cells,
 cAMP,  fluid secretion
Profuse watery
into SI (pores) Long incubation
diarrhea

TCP (pilus): adherence to - Cholera cots

mucosal lining. Lysogenic - “rice water” stools.
Bacteriophage (CTX): - TCBS agar
carries toxin. Profuse watery - Tx: fluid replacement,
Cholera Toxin: enterotoxin, Fecally- diarrhea and antibiotics
Vibrio cholerae activates adenylate cyclase contaminated water vomiting,
hypovolemic shock

 Gram (-) bacilli

 Curved rod
 Oxidase (+) Direct invasion Dx: TCBS agar (blue-green
Vibrio  Alkalophile Explosive watery colonies), requires salt for
Raw seafood
parahaemolyticu  O-antigen diarrhea, mild fever, growth
(oysters)
abd pain, vomiting
s
Capsule: bloodstream TCBS agar
survival. Diarrhea, septicemia, (blue-green)
RtxA toxin: pore-forming, Raw seafood, wound
Vibrio vulnificus induces ROS infections
cellulitis, bullous,
necrotic skin lesions
 ETEC: Antibiotics can worsen
CFA (pili): adhesion.
Stable Toxin (STa): converts
GTP to cGMP, Travelers, fecally-
hypersecretions. Watery diarrhea, mild
contaminated
Labile Toxin (LT) fever, no RBC/WBC
water/food

EPEC:
Bundle-Forming Pilus (BFP):
binds receptors,
aggregation. Watery diarrhea,
A/E lesions, Tir receptor Children, neonatal
hypovolemia,
binds intimin, actin nursey outbreaks, Persistent
malnutrition, death,
rearrangement direct contact
no RBC/WBC
 Gram (-) bacilli
 Facultative an.
Escherichia coli  Oxidase (-)
 Lactose ferm. EAEC:
Adherence fimbriae (AAFs),
cytotoxins causes rounding
Children, adult HIV
of villi, biofilms Watery diarrhea Persistent
patients

EHEC, STEC: - O157:H7 -Hemolytic

Shiga Toxin 1/2: inhibits Uremic Syndrome (HUS):
protein synthesis, A/E hemolytic anemia,
lesions. No BFP schistocytes,
Watery diarrhea, abd thrombocytopenia,
Children, meat, leukocytosis.
cramping, bloody
vegetables - SMAC agar
diarrhea

EIEC:
Similar to Shigella, direct Watery diarrhea,
tissue invasion dysentery

 Gram (-) bacilli Urease: protects against False appendicitis

 Facultative an. stomach acids. Watery diarrhea, low-
Yersinia  Oxidase (-) Enterotoxin.
Milk, dairy
grade fever,
enterocolitica  Non-lactose f. To mesenteric nodes leukocytosis,
 H2S (-) pharyngitis
 Bipolar staining
Non-Typhoidal: invades M Salmonellosis
cells in Peyer Patches, (gastroenteritis)
replicates in endocytic
Watery diarrhea,
vacuoles Eggs, poultry, dairy
cramps, fever
 Gram (-) bacilli
 Facultative an.
Salmonella  Oxidase (-)
enterica  Non-lactose f. Salmonella Typhi: Type III - “Typhoid Mary”
 H2S secretion, infects bone - low infectious dose
 Motile marrow, liver, spleen,
Diarrhea, constipation
gallbladder
high fever

S. sonnei: attach to M cells “Shigella does nothing but

in Peyer Patches, actin tails shit”
Day care centers,
 Gram (-) bacilli Mild diarrhea
developed countries
 Facultative an.
 Oxidase (-)
Shigella spp.  Non-lactose f. S. dysenteriae: shiga toxin HUS
 H2S (-) (Stx) Shigellosis: bloody
 Non-motile Developing
diarrhea, tenesmus,
countries
inflammation
 - Guillain-Barre syndrome,
 Gram (-) bacilli - skirrow medium
 Curved rod
Campylobacter  Aerobic Raw poultry Bloody diarrhea
jejuni  Oxidase (+)
 Grows at 42C

Facultative intercellular - Cold temps

parasite, enters via - Fetal loss (placental
 Gram (+) bacilli
Listeria internalins transfer)
 Non-spore Soft cheeses, deli Diarrhea, muscle
monocytogenes  Aerobic meats aches, arthralgia
 Catalase (+)

Acute Viral Gastroenteritis

Name Characteristics Source Symptoms Other

 Caliciviridae Institutional settings

Sudden onset vomiting and Acute infectious diarrhea,
Norovirus  Fecal-oral (schools, hospitals, hotels,
watery diarrhea, no fever self-limiting, short duration
 Cooler months cruise ships, camps)

 Cooler months Sudden onset vomiting, Childhood diarrhea

Rotavirus  Affects very young and Institutional settings watery diarrhea, epidemics, self-limiting, long
elderly dehydration, low-grade fever duration

 Enteric
Asymptomatic, watery
(serotypes 40, 41)
Adenovirus  Affects very young
Institutional settings diarrhea, mucus in stool, Self-limiting
vomiting
 No seasonality

 Cooler months
 Rainy seasons Self-limiting, less severe than
Astrovirus  Infants, children, elderly,
Institutional settings Watery diarrhea
Rotavirus
immuno.