CHAPTER ONE

1.1 INTRODUCTION

Foodborne illness usually arises from improper handling, preparation, or food storage. Good

hygiene practices before, during, and after food preparation can reduce the chances of

contracting an illness. There is a consensus in the public health community that regular hand

washing is one of the most effective defenses against the spread of foodborne illness (Marasas,

2020). Food poisoning, also called food borne illness, is illness caused by eating contaminated

food. Infectious organisms including bacteria, viruses and parasites or their toxins are the most

common causes of food poisoning. It's not usually serious and most people get better within a

few days without treatment. Statistically speaking, nearly everyone will come down with food

poisoning at least once in their lives. The best way to prevent food poisoning is to handle your

food safely and to avoid any food that may be unsafe (Adejumo et al., 2017).

Food poisoning, also called food borne illness, is illness caused by eating contaminated

food. Infectious organisms including bacteria, viruses and parasites or their toxins are the most

common causes of food poisoning. It's not usually serious and most people get better within a

few days without treatment. In most cases of food poisoning, the food is contaminated by

bacteria, such as salmonella or Escherichia coli (E. coli), or a virus, such as the norovirus.

Infectious organisms or their toxins can contaminate food at any point of processing or

production (Adejumo and Hettwer.,et al, 2017 ). Contamination can also occur at home if food is

incorrectly handled or cooked. Food poisoning symptoms, which can start within hours of eating

contaminated food, often include nausea, vomiting or diarrhea. Most often, food poisoning is

mild and resolves without treatment. But some people need to go to the hospital. Although it’s
quite uncomfortable, food poisoning isn’t unusual. According to the Centers for Disease Control

and Prevention (CDC) Trusted Source, 1 in 6 Americans will contract some form of food

poisoning every year (Hedberg ., et al.2017).

Foodborne illness is caused by the ingestion of contaminated food by an individual. There are

two main types of foodborne illnesses. The first, generally referred to as food poisoning, occurs

when a person ingests a food that contains a foodborne pathogen and illness results. The second

type is commonly referred to as “foodborne intoxication” and occurs when a pre-formed toxin,

made by a microorganism, is ingested by the person, resulting in illness (David, 2008).

Common examples of food poisoning organisms include Listeria monocytogenes, Salmonella

enterica and Campylobacter spp. Examples of food intoxication include Staphylococcus

aureus and Bacillus cereus intoxications, as well as the seafood toxins such as paralytic shellfish

toxin/poisoning and domoic acid. Although many people think that you only have mild diarrhea,

stomach cramps and/or vomiting with foodborne illness, this can be far from the truth. In fact,

there can be very dangerous “sequelae” or complications arising after the initial foodborne

infection. Some examples include arthritis after a Salmonella infection, neurological disorders

such as Guillain-Barré syndrome after a Campylobacter infection and kidney

complications/failure from hemolytic-uremic syndrome (HUS), which can occur as a result of an

initial E. coli O157:H7 infection. Death can also occur after a foodborne illness (Micheal and

Adley 2016).

For example, in high-risk individuals, the mortality rate of a Listeria monocytogenes infection

can approach close to 40% in outbreak situations, such as was observed in the deli-meat outbreak

which occurred in Canada in 2008.

FOOD POISONING AND FOOD ILLNESS

Foodborne Illnesses

A foodborne illness is any illness that results from consuming food contaminated with

pathogenic microorganisms, or toxic compounds released by microorganisms. The disease-

causing microorganisms are most often bacteria, but can also include fungi, viruses and protozoa.

Your food usually travels a long distance from its origin before it gets to your plate. It can be

handled by many different people and exposed to many different conditions (David, 2008).

This results in many potential points where food can become contaminated. Some microbes

responsible for foodborne illnesses are members of the normal microflora of the food organism.

So, for example, the bacteria that are naturally found in the cow intestinal tract can end up

contaminating the slabs of beef during butchering. This kind of contamination can occur during

slaughter or during any point in the food's processing. Vegetables and fruits are not immune to

contamination with foodborne pathogens, despite the fact that they are picked, not slaughtered.

Irrigation water or fertilizers sprayed on crops can be contaminated with animal or human waste

containing foodborne pathogens (Micheal and Adley 2016).

Food Poisoning

Food poisoning, also called food intoxication, is any illness caused by ingesting food containing

preformed microbial toxins. The microbes don't need to be alive or actively growing at the time

of consumption. They form the toxins and release them directly into the food. The toxins

generally cause symptoms immediately, only taking around one to six hours to develop. The time
to develop symptoms can vary depending on the kind of toxin and its concentration in the food.

Let's use the example of Clostridium botulinum, the causative agent behind botulism food

poisoning. C. botulinum will only grow in protein-rich environments with no oxygen. When C.

botulinum is actively growing, it releases a toxin into its environment (Micheal and Adley 2016)
 CHAPTER TWO

2.1 SELECTED REVIEW

2.1.1 INCUBATION PERIOD

The delay between the consumption of contaminated food and the appearance of the first

symptoms of illness is called the incubation period. This ranges from hours to days depending on

the agent, and on how much was consumed. If symptoms occur within one to six hours after

eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than life

bacteria (Marasas, 2020). The long incubation period of many foodborne illnesses tends to cause

sufferers to attribute their symptoms to gastroenteritis. During the incubation period, microbes

pass through the stomach into the intestine, attach to the cells lining the intestinal walls, and

begin to multiply there. Some types of microbes stay in the intestine, some produce a toxin that

is absorbed into the bloodstream, and some can directly invade the deeper body tissues. The

symptoms produced depend on the type of microbe (Froquet R., et al. 2016).

2.1.2 INFECTIOUS DOSE

The infectious dose is the amount of agent that must be consumed to give rise to symptoms of

foodborne illness, and varies according to the agent and the consumer's age and overall health.

Pathogens vary in minimum infectious dose; for example, Shigella sonnei has a low estimated

minimum dose of < 500 colony-forming units (CFU) while Staphylococcus aureus has a

relatively high estimate. In the case of Salmonella a relatively large inoculum of 1 million to 1

billion organisms is necessary to produce symptoms in healthy human volunteers, (Greig.,et

al.2019) as Salmonellae are very sensitive to acid. An unusually high stomach pH level (low
acidity) greatly reduces the number of bacteria required to cause symptoms by a factor of

between 10 and 100 (Froquet et al., 2016).

2.2 PREVENTION OF FOOD POISONING

The best way to prevent food poisoning is to handle your food safely and to avoid any food that

may be unsafe. Some foods are more likely to cause food poisoning because of the way they’re

produced and prepared (Dubois et al., 2016).. Meat, poultry, eggs, and shellfish may harbor

infectious agents that are killed during cooking. If these foods are eaten in their raw form, not

cooked properly, or if hands and surfaces are not cleaned after contact, food poisoning can occur.

To prevent food poisoning at home (Froquet et al., 2016).

i. Wash your hands, utensils and food surfaces often. Wash your hands well with warm,

soapy water before and after handling or preparing food. Use hot, soapy water to

wash utensils, cutting boards and other surfaces you used (Dubois et al., 2016).

ii. Keep raw foods separate from ready-to-eat foods. When shopping, preparing food or

storing food, keep raw meat, poultry, fish and shellfish away from other foods. This

prevents cross-contamination (Dubois et al., 2016).

iii. Cook foods to a safe temperature. The best way to tell if foods are cooked to a safe

temperature is to use a food thermometer. You can kill harmful organisms in most

foods by cooking them to the right temperature.

Cook ground beef to 160 F (71.1 C); steaks, roasts and chops, such as lamb, pork and veal, to at

least 145 F (62.8 C). Cook chicken and turkey to 165 F (73.9 C). Make sure fish and shellfish are

cooked thoroughly (Dubois et al., 2016).

 iv. Refrigerate or freeze perishable foods promptly — within two hours of purchasing or

preparing them. If the room temperature is above 90 F (32.2 C), refrigerate perishable

foods within one hour.

v. Defrost food safely. Don't thaw food at room temperature. The safest way to thaw

food is to defrost it in the refrigerator. If you microwave frozen food using the

"defrost" or "50 percent power" setting, be sure to cook it immediately.

vi. Throw it out when in doubt. If you aren't sure if a food has been prepared, served or

stored safely, discard it. Food left at room temperature too long may contain bacteria

or toxins that can't be destroyed by cooking. Don't taste food that you're unsure about

— just throw it out. Even if it looks and smells fine, it may not be safe to eat

(Hedberg CW., et al.2017).

Food poisoning is especially serious and potentially life-threatening for young children,

pregnant women and their fetuses, older adults, and people with weakened immune systems.

These individuals should take extra precautions by avoiding the following foods:

i. Raw or rare meat and poultry

ii. Raw or undercooked fish or shellfish, including oysters, clams, mussels and scallops

iii. Raw or undercooked eggs or foods that may contain them, such as cookie dough and

homemade ice cream (Hedberg CW., et al.2017).

iv. Raw sprouts, such as alfalfa, bean, clover and radish sprouts

v. Unpasteurized juices and ciders

vi. Unpasteurized milk and milk products

vii. Soft cheeses, such as feta, Brie and Camembert; blue-veined cheese; and

unpasteurized cheese
 viii. Refrigerated pates and meat spreads

ix. Uncooked hot dogs, luncheon meats and deli meats

2.3 TREATMENT OF FOOD POISONING

Food poisoning can usually be treated at home without seeking medical advice. Most people

will feel better within a few days. It's important to avoid dehydration by drinking plenty of water,

even if you can only sip it, as you need to replace any fluids lost through vomiting and diarrhoea.

You should do the following:

 Rest as much as possible

 Eat when you feel up to it sticking to small, light and non-fatty meals at first (bland

foods such as toast, crackers, rice and bananas are good choices)

 Avoid alcohol, caffeine, fizzy drinks and spicy and fatty foods because they may make

you feel worse

Contact your GP if your symptoms are severe or don't start to improve in a few days. If you

have food poisoning, you shouldn't prepare food for other people and you should try to keep

contact with vulnerable people, such as the elderly or very young, to a minimum. If someone you

live with has food poisoning, you should:

 Make sure everyone in your household (including yourself) washes their hands with soap

and warm water regularly – particularly after going to the toilet and before and after

preparing food (Hedberg CW., et al.2017).

 Clean surfaces, toilet seats, flush handles, basins and taps frequently
  Make sure everyone has their own towels and flannels

 Wash the laundry of the infected person on the hottest washing machine setting

Oral rehydration solutions (ORS) are recommended for people vulnerable to the effects of

dehydration, such as the elderly and those with a pre-existing health condition. ORSs are

available in sachets from pharmacies (Marasas WF., 2020). You dissolve them in water to drink

and they help replace salt, glucose and other important minerals your body loses through

dehydration (Marasas WF.,2020). If your symptoms are severe or persistent, or you are more

vulnerable to serious infection (for example, because you are elderly or have an underlying

health condition), you may need further treatment. Tests may be carried out on a stool sample to

find out what it causing your symptoms and antibiotics may be prescribed if the results show you

have a bacterial infection. Medication to stop you vomiting (anti-emetics) may also be prescribed

if your vomiting is particularly severe. In some cases, you may need to be admitted to hospital

for a few days so you can be monitored and given fluids directly into a vein (intravenously)

(Marasas, 2020).

2.4 FACTORS CONTRIBUTING TO OUTBREAKS

Salmonella

Salmonella infection, caused by a gram-negative rod-shaped bacterium, is characterized by fever,

abdominal pain, and diarrhea that occur between 12 and 72 hours after ingestion of contaminated

foods (Marasas, 2020). It can also be transmitted through contact with infected animals.

Salmonella enterica bacteria occur in more than 2,500 pathogenic serotypes and cause an

estimated 1.2 million infections yearly in the United States (Malvinder, et al., 2019). The most

common serotypes in the United States are Salmonella serotype Typhimurium and serotype
Enteritidis. Salmonella Typhi, the etiologic agent for typhoid fever, while common in the

developing world, is rare in the United States, with an estimated 400 cases per year, 75% of

which occur in international travelers (Marasas, 2020). Recently, an overall increase in

foodborne Salmonella infections has been seen, including multistate outbreaks caused by

contaminated pot pies, peanut butter, raw tomatoes, and fruit salad [34–37]. Salmonella bacteria

normally inhabit the intestinal tracts of human beings and animals, including birds, and human

infection is usually caused by contact with animal feces or with infected animals, such as

reptiles. Although any food can be contaminated with Salmonella, complete cooking kills the

bacterium. Consumption of raw animal products that may harbor Salmonella, such as raw eggs,

undercooked chicken, and beef, should be avoided. A 2007 outbreak of Salmonella

Typhimurium infection was attributed to the consumption of raw (ie, unpasteurized) milk from a

Pennsylvania dairy. Before the advent of widespread pasteurization of dairy products in the early

twentieth century, infections from raw milk or cheese accounted for up to 25% of the foodborne

infections in the United States (Malvinder, et al., 2019). Despite the clear health risks, some

consumers continue to consume raw milk and raw milk products, either for taste or for perceived

health benefits. Characterized by fever, abdominal cramps, and diarrhea, which may be bloody,

Salmonella infection tends to be self-limited and most individuals infected with Salmonella

recover within 5 to 7 days with supportive care.

Clostridium perfringens

Like other Clostridia species, Clostridium perfringens is an anaerobic, gram-positive, spore-

forming bacterium. These heat-activated spores grow in food, particularly meat and poultry,

subsequently producing an enterotoxin in the small intestine when ingested (Malvinder, et al.,

2019). Symptoms include profuse watery diarrhea, accompanied by severe abdominal cramping
and gas. The time of onset is usually delayed approximately 8 to 16 hours after ingestion of

contaminated foods. Most outbreaks of C. perfringens are related to poor temperature control of

cooked or reheated foods, especially meats, meat products, and gravy. C. perfringens spores can

resist high temperatures, then germinate during cooling, leading to live vegetative forms of the

organism that can be ingested if foods are not properly reheated before serving. Two large

outbreaks of C. perfringens food poisoning that occurred on St. Patrick’s Day, 1993 in Ohio and

Virginia, related to improperly reheated corned beef, affecting over 100 patients (Malvinder, et

al., 2019). The disease course for C. perfringens foodborne illness tends to be self limited,

requiring only supportive care, and resolving within 12 to 24 hours. As previously noted, there is

some thought that the common ‘‘24-hour flu’’ may actually be caused by C. perfringens

gastroenteritis (Lucie et al., 2017). The diagnosis is clinical, except in the case of multiple patient

outbreaks where stool cultures or analysis of leftover foods may be obtained.

E. coli

E. coli O157:H7 Largely because of several recent multistate outbreaks, E. coli O157:H7 has

achieved a certain notoriety as a highly pathogenic foodborne illness. Outbreaks involving fresh

spinach, fast food restaurants, and ground beef patties have caused dozens of consumers to fall ill

and several deaths, primarily because of the subsequent development of HUS. E. coli O157:H7, a

Shiga-toxin producing strain of E. coli (STEC), is a gram-negative rod-shaped enteric bacterium

that typically causes a gastroenteritis type picture characterized by bloody diarrhea, abdominal

cramps, and little if any fever. An infectious colitis can also result from STEC infection,

characterized on computed tomographic imaging by abnormal colonic wall thickening and

pericolonic stranding (Lucie et al., 2017). STEC infection is most often transmitted by fecal-oral
contamination, as is the case with other enteric pathogens such as Salmonella, Campyliobacter,

or Shigella (Lucie et al., 2017).

Staphylococcus aureus

One of the most common causes of foodborne illness, Staphylococcus aureus is a gram-positive

coccoid bacterium that produces a heat-stable enterotoxin during the growth of S. aureus in food

(Lucie et al., 2017). These enterotoxins, of which there are seven known subtypes, are

responsible for the clinical picture typically seen in patients with foodborne illness caused by S.

aureus. Additional enterotoxins generated by S. aureus are responsible for the various other

manifestations of staphylococcal disease, including toxic shock syndrome and staphylococcal

scalded skin syndrome. Patients with S. aureus-related gastrointestinal symptoms most often

present with nausea, crampy abdominal pain, and vomiting, usually within 1 to 6 hours of

ingestion of contaminated foods (Li FQ, et al., 2016). Diarrhea is often present but tends to be

less characteristic of patients with S. aureus food poisoning. The duration of symptoms is

generally less than 2 days. The ingestion of a preformed toxin leads to the rapid onset of

symptoms without a prolonged incubation period, as is typically seen in patients with

Salmonellosis. While S. aureus must multiply in contaminated food to form enough toxin to

cause illness (greater than 106 colony-forming units per gram), its incubation period is relatively

short, from 30 minutes to 8 hours, with an average of 1 to 6 hours. The most common cause of S.

aureus food contamination is through direct contact with food workers carrying the bacterium or

through contaminated dairy products. It is estimated that the prevalence of nasal colonization

with S. aureus in the general population is up to 25% (Lucie et al., 2017). Food products that
have been typically responsible for S. aureus-related foodborne illness include meat and meat

products; poultry and egg products; salads such as egg, tuna, potato, and macaroni; foods that are

handled directly; cream-filled pastries; and casseroles.

 CHAPTER THREE

3.1 CAUSES OF FOOD POISONING

Foodborne illness usually arises from improper handling, preparation, or food storage. Good

hygiene practices before, during, and after food preparation can reduce the chances of

contracting an illness. There is a consensus in the public health community that regular hand

washing is one of the most effective defenses against the spread of foodborne illness (Greig,

2019). The action of monitoring food to ensure that it will not cause foodborne illness is known

as food safety. Foodborne disease can also be caused by a large variety of toxins that affect the

environment (Hay, 2017). Furthermore, foodborne illness can be caused by pesticides or

medicines in food and natural toxic substances such as poisonous mushrooms or reef fish. Most

food poisoning can be traced to one of the following three major causes (Adejumo et al., 2017).

3.1.1 BACTERIA

Bacteria are by far the most prevalent cause of food poisoning. When thinking of dangerous

bacteria, names like E. coli, Listeria, and Salmonella come to mind for good reason. Salmonella

is by far the biggest culprit of serious food poisoning cases in the United States (Greig, 2019). In

the past, bacterial infections were thought to be more prevalent because few places had the

capability to test for norovirus and no active surveillance was being done for this particular

agent. Toxins from bacterial infections are delayed because the bacteria need time to multiply
(Hedberg CW., et al.2017). As a result, symptoms associated with intoxication are usually not

seen until 12–72 hours or more after eating contaminated food. However, in some cases, such as

Staphylococcal food poisoning, the onset of illness can be as soon as 30 minutes after ingesting

contaminated food (Greig, 2019). According to the CDC Trusted Source, an estimated 1,000,000

cases of food poisoning, including nearly 20,000 hospitalizations, can be traced to salmonella

infection annually. Campylobacter and C. botulinum (botulism) are two lesser-known and

potentially lethal bacteria that can lurk in our food. Most common bacterial foodborne pathogens

are:

 Campylobacter jejuni which can lead to secondary Guillain–Barré syndrome and periodontitis

 Clostridium perfringens, the "cafeteria germ"(Greig, 2019).

 Salmonella spp. – its S. typhimurium infection is caused by consumption of eggs or poultry

that are not adequately cooked or by other interactive human-animal pathogens

 Escherichia coli O157:H7 enterohemorrhagic (EHEC) which can cause hemolytic-uremic

syndrome (Adejumo et al., 2017).

Other common bacterial foodborne pathogens are:

 Bacillus cereus

 Escherichia coli, other virulence properties, such as enteroinvasive (EIEC), enteropathogenic

(EPEC), enterotoxigenic (ETEC), enteroaggregative (EAEC or EAgEC) (Adejumo et al., 2017).

 Listeria monocytogenes

 Shigella spp.
 Staphylococcus aureus

 Staphylococcal enteritis

 Streptococcus

 Vibrio cholerae, including O1 and non-O1

 Vibrio parahaemolyticus

 Vibrio vulnificus

 Yersinia enterocolitica and Yersinia pseudotuberculosis

Less common bacterial agents:

 Brucella spp.

 Corynebacterium ulcerans

 Coxiella burnetii or Q fever

 Plesiomonas shigelloides (Adejumo et al., 2017).

3.1.2 PARASITES

Food poisoning caused by parasites is not as common as food poisoning caused by bacteria, but

parasites spread through food are still very dangerous. Toxoplasma is the parasite seen most

often in cases of food poisoning (Hedberg CW., et al. 2017). It’s typically found in cat litter

boxes. Parasites can live in your digestive tract undetected for years. However, people with

weakened immune systems and pregnant women risk serious side effects if parasites take up
residence in their intestines (Greig, 2019). Most foodborne parasites are zoonoses.

Platyhelminthes:

 Diphyllobothrium sp.

 Nanophyetus sp.

 Taenia saginata

 Taenia solium

 Fasciola hepatica Nematode:

 Anisakis sp.

 Ascaris lumbricoides

 Eustrongylides sp.

 Trichinella spiralis

 Trichuris trichiura Protozoa:

 Acanthamoeba and other free living amoebae (Adejumo et al., 2017).

 Cryptosporidium parvum

 Cyclospora cayetanensis

 Entamoeba histolytica

 Giardia lamblia (Froquet et al., 2016).

 Giardia lamblia

 Sarcocystis hominis

 Sarcocystis suihominis

 Toxoplasma gondii (Froquet et al., 2016).

3.1.3 VIRUSES

Viral infections make up perhaps one third of cases of food poisoning in developed countries.

Food poisoning can also be caused by a virus. The norovirus, also known as the Norwalk virus,

causes over 19 million cases Trusted Source of food poisoning each year (Joffe AZ, Yagen B.,

2017). In rare cases, it can be fatal. Sapovirus, rotavirus, and astrovirus bring on similar

symptoms, but they’re less common. Hepatitis A virus is a serious condition that can be

transmitted through food (Froquet et al., 2016). In developed countries, more than 50% of cases

are viral and noroviruses are the most common foodborne illness, causing 57% of outbreaks in

2004. Foodborne viral infection are usually of intermediate (1–3 days) incubation period, causing

illnesses which are self-limited in otherwise healthy individuals; they are similar to the bacterial

forms described above.

Enterovirus

 Hepatitis A is distinguished from other viral causes by its prolonged (2–6 week) incubation

period and its ability to spread beyond the stomach and intestines into the liver. It often results in

jaundice, or yellowing of the skin, but rarely leads to chronic liver dysfunction. The virus has

been found to cause infection due to the consumption of fresh-cut produce which has fecal

contamination (Froquet et al., 2016).

 Hepatitis E

 Norovirus

 Rotavirus

3.2 SYMPTOMS OF FOOD POISONING

Statistically speaking, nearly everyone will come down with food poisoning at least once in their

lives. There are some populations that are more at risk than others (Greig, 2019). Anyone with a

suppressed immune system or an auto-immune disease may have a greater risk of infection and a

greater risk of complications resulting from food poisoning. According to the (Li F, et al., 2000),

pregnant women are more at risk because their bodies are coping with changes to their

metabolism and circulatory system during pregnancy. Elderly individuals also face a greater risk

of contracting food poisoning because their immune systems may not respond quickly to

infectious organisms. Children are also considered an at-risk population because their immune

systems aren’t as developed as those of adults. Young children are more easily affected by

dehydration from vomiting and diarrhea (Greig, 2019).

Four well-known, classic symptoms are typical of gastroenteritis:

 Diarrhea (loose stools)

 Nausea (feeling sick or queasy)

 Vomiting
 Abdominal pain ('stomach cramps') (Hay 2017).

These symptoms can occur in any combination; they generally have a sudden (acute) onset, but

this, and symptom severity, can vary (Hay 2017). The onset of symptoms after eating

contaminated food can be within a few hours, but the incubation period can also be much longer,

depending on the pathogen involved. Vomiting usually happens earlier on in the disease,

diarrhea usually lasts for a few days, but can be longer depending on the organism that is causing

the symptoms (Li FQ, et al., 2016).

3.3 CONTROL OF FOODBORNE ILLNESS AND FOOD POISONING

Everyone has a role to play in preventing or controlling foodborne illness. This includes

consumers, the food industry and governments. The food industry has the primary responsibility

for producing safe food, while governments provide the regulatory oversight needed to ensure

that the food industry is following the correct practices and procedures that will lead to a safe

food supply.

I. Food Industry Controls

Controls performed by the food industry can generally be broken down into pre-harvest and post-

harvest controls.

i) Pre-Harvest:

Recently, foodborne illnesses due to fruits and vegetables appear to be increasing. Some

examples of control measures for produce that can be done at the pre-harvest stage on the farm

(referred to as on-farm food safety) include the use of properly treated water, monitoring the

health and hygiene of farm workers, improved on-farm sanitation, and restricting the access of
livestock and other animals to crops and to surface waters. Good hygienic practices by farm

workers involved in the cultivation, harvesting, processing, or packaging of fresh produce are

also very important in terms of reducing the likelihood of contamination at the farm level. The

availability of toilets and hand-washing facilities for farm workers is also an important control

measure. Other pre-harvest examples besides the produce area, include the need for quality

assurance programs at egg farms and programs to keep shellfish harvest beds free of sewage

contamination.

ii) Post-Harvest:

Food companies processing ready-to-eat (RTE) food should have effective good manufacturing

practices (GMPs) and a HACCP (Hazard Analysis and Critical Control Points) system in place to

minimize all potential sources of food contamination. These should address the potential for

foodborne pathogens such as L. monocytogenes to be present in the environment of their

processing establishment. In this regard, the importance of sanitation should not be overlooked.

RTE food processors should also strongly consider introducing within their food safety systems

one or more validated controls for the elimination of foodborne pathogens from their products

(e.g., use of a post-lethality treatment). Furthermore, environmental and end-product sampling

plans and the use of microbiological testing as a verification tool to demonstrate the effectiveness

of the control measures put in place to address pathogens such as L. monocytogenes are

recommended. Food processing plants should also carry out regular environmental sampling to

verify the effectiveness of their sanitation programs. The use of pasteurization, high-pressure

processing, canning, cooking, irradiation, and other steps to kill pathogens in food processing are

important tools that the food industry should be using.

iii) Foodservice:

There are many foodborne outbreaks that occur in restaurants. Examples of some control

measures for restaurants include training for restaurant managers and food workers about food

safety and sanitation measures, having standardized procedures and cooking protocols in place,

having a certified kitchen manager on site at all times, emphasizing proper hand-washing

procedures and facilities, and making sure that policies and procedures are in place to make sure

that ill employees do not come into work. One can encourage food workers not to work when

they are ill, for example, by providing paid sick leave.

iv) Retail:

The key factors involved in the control of foodborne pathogens at retail include the prevention of

cross-contamination, practicing proper sanitation and controlling time and temperature. Cleaning

and sanitizing is the number one control available to minimize the spread of pathogens at retail,

while temperature is the number one control available to minimize the growth of pathogens at

retail. Employee training is also critical. In nigeria, food service workers must pass an annual

health examination, and are subject to mandatory training in sanitation requirements relevant to

their positions. The resulting Health Certificate is updated annually.

The following have been identified as ‘key’ components in the control of pathogens at retail,

including L. monocytogenes:

i) sourcing from inspected suppliers indicates that the food has passed the initial government

inspection for food safety;

ii) avoiding/minimizing contamination and cross-contamination at each stage of retail receiving

and handling;
iii) cleaning and sanitizing, as mentioned above, are the number one controls available to the

retail sector to minimize the spread of pathogens;

iv) temperature control is vital, as refrigeration temperatures inhibit or slow the growth of

foodborne pathogens; v) the appropriate durable life should be displayed on products;

v) product rotation should be done such that foods with an earlier best-before date should be

offered for sale and consumed before food with a later best-before date;

vi) employee training, including personal hygiene practices; and

vii) implementation of a HACCP-based approach to minimize the spread and growth of

pathogens, including L. monocytogenes, at the retail level.

II. Consumers:

Educational material directed at the consumer should be continuously updated and evaluated for

its effectiveness. Consumers should be taught the basics of food safety, for example - cook, chill,

clean and separate (Li FQ, et al., 2016). Cleaning anything that comes into contact with food will

help eliminate bacteria and reduce the risk of foodborne illness. This includes your hands,

kitchen surfaces, utensils and reusable grocery bags. It is important to keep cold food cold and

hot food hot, so that your food never reaches the "temperature danger zone." This is where

bacteria can grow quickly and cause food poisoning. Cooking food properly is the best way to

make sure it is safe to eat. The importance of preventing cross-contamination in the kitchen

should also be emphasized. For certain pathogens such as L. monocytogenes, educational efforts

should be directly targeted to at-risk groups such as pregnant women, people with weakened

immune systems and the elderly (> 65 years of age).

III. Government
Governments develop food safety standards and policies to help minimize the risk of foodborne

illnesses. Agencies oversee the food industry to ensure that it meets its food safety

responsibilities, and conduct targeted surveys of foods for specific pathogens. Governments may

also conduct either passive and/or active surveillance of human illnesses, and to investigate the

source of any food-related illnesses, especially when an outbreak is suspected. In addition,

governments may provide reference laboratory services, perform risk-based inspections, conduct

food safety investigations, and perform health risk assessments and conduct recall actions when

required (Li FQ, et al., 2016). Governments can also brief the medical community, public health

officials, the food industry and consumers on issues related to contaminated foods and foodborne

outbreak investigations, as well as to develop educational material for both consumers and the

food industry.
 CHAPTER FOUR

4.1 CONCLUSION

While having food poisoning is quite uncomfortable, the good news is that most people

recover completely within 48 hours. Food poisoning can be life threatening, however the CDC

says this is extremely rare. It’s advisable to hold off on solid foods until vomiting and diarrhea

have passed and instead ease back to your regular diet by eating simple-to-digest foods that are

bland and low in fat, such as: saltine crackers, gelatin, bananas, rice, oatmeal etc. To prevent

your stomach from getting more upset, try to avoid the following harderto-digest foods, even if

you think you feel better: dairy products, especially milk and cheeses, fatty foods, highly

seasoned foods, food with high sugar content, spicy foods, fried foods, caffeine (soda, energy

drinks, coffee), alcohol.

4.2 RECOMMENDATION

It is highly recommended that individual should:

 Wash your hands, utensils and food surfaces often. Wash your hands well with warm,

soapy water before and after handling or preparing food. Use hot, soapy water to wash

utensils, cutting boards and other surfaces you used.

 Keep raw foods separate from ready-to-eat foods. When shopping, preparing food or

storing food, keep raw meat, poultry, fish and shellfish away from other foods. This

prevents cross-contamination.
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