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Foodborne Disease
Handbook
FOODBORNE DISEASE HANDBOOK
Editor-in-Chief
Y. H. Hui
Volume Editors
J. Richard Gorham
David Kitts
K. D. Murrell
Wai-Kit Nip
Merle D. Pierson
Syed A. Sattar
R. A. Smith
David G. Spoerke, Jr.
Peggy S. Stanfield
Volume 1 Bacterial Pathogens Volume 3 Plant Toxicants
Volume 2 Viruses, Parasites, Volume 4 Seafood and

Pathogens, and HACCP Environmental Toxins
Foodborne Disease
Handbook
Second Edition, Revised and Expanded
Volume 2: Viruses, Parasites, Pathogens, and HACCP
edited by
Y. H. Hui
Science Technology System
West Sacramento, California
Syed A. Sattar
University of Ottawa
Ottawa, Ontario, Canada
K. D. Murrell
U.S. Department of Agriculture
Beltsville, Maryland
Wai-Kit Nip
University of Hawaii at Manoa
Honolulu, Hawaii
Peggy S. Stanfield
Dietetics Resources
Twin Falls, Idaho
MARCEL DEKKER, INC.

Boca Raton London New York
NEW YORK • BASEL
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First published 2001 by CRC Press
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Introduction to the Handbook
The Foodborne Disease Handbook, Second Edition, Revised and Expanded, could not be
appearing at a more auspicious time. Never before has the campaign for food safety been
pursued so intensely on so many fronts in virtually every country around the world. This
new edition reflects at least one of the many aspects of that intense and multifaceted
campaign: namely, that research on food safety has been very productive in the years
since the first edition appeared. The Handbook is now presented in four volumes instead
of the three of the 1994 edition. The four volumes are composed of 86 chapters, a 22%
increase over the 67 chapters of the first edition. Much of the information in the first
edition has been carried forward to this new edition because that information is still as
reliable and pertinent as it was in 1994. This integration of the older data with the latest
research findings gives the reader a secure scientific foundation on which to base important
decisions affecting the public's health.
We are not so naive as to think that only scientific facts influence decisions affecting
food safety. Political and economic factors and compelling national interests may carry
greater weight in the minds of decision-makers than the scientific findings offered in this
new edition. However, if persons in the higher levels of national governments and interna-
tional agencies, such as the Codex Alimentarius Commission, the World Trade Organiza-
tion, the World Health Organization, and the Food and Agriculture Organization, who
must bear the burden of decision-making need and are willing to entertain scientific find-
ings, then the information in these four volumes will serve them well indeed.
During the last decade of the previous century, we witnessed an unprecedentedly
intense and varied program of research on food safety, as we have already noted. There
are compelling forces driving these research efforts. The traditional food-associated patho-
gens, parasites, and toxins of forty years ago still continue to cause problems today, and
newer or less well-known species and strains present extraordinary challenges to human
health.
These newer threats may be serious even for the immunocompetent, but for the
immunocompromised they can be devastating. The relative numbers of the immunocom-
promised in the world population are increasing daily. We include here not just those
affected by the human immunodeficiency virus (HIV), but also the elderly; the very young;
the recipients of radiation treatments, chemotherapy, and immunosuppressive drugs; pa-
//'/'
iv Introduction to the Handbook
dents undergoing major invasive diagnostic or surgical procedures; and sufferers of debili-
tating diseases such as diabetes. To this daunting list of challenges must be added numer-
ous instances of microbial resistance to antibiotics.
Moreover, it is not yet clear how the great HACCP experiment will play out on the
worldwide stage of food safety. Altruism and profit motivation have always made strange
bedfellows in the food industry. It remains to be seen whether HACCP will succeed in
wedding these two disparate motives into a unifying force for the benefit of all con-
cerned—producers, manufacturers, retailers, and consumers. That HACCP shows great
promise is thoroughly discussed in Volume 2, with an emphasis on sanitation in a public
eating place.
All the foregoing factors lend a sense of urgency to the task of rapidly identifying
toxins, species, and strains of pathogens and parasites as etiologic agents, and of determin-
ing their roles in the epidemiology and epizootiology of disease outbreaks, which are
described in detail throughout the Foodborne Disease Handbook.
It is very fortunate for the consumer that there exists in the food industry a dedicated
cadre of scientific specialists who scrutinize all aspects of food production and bring their
expertise to bear on the potential hazards they know best. A good sampling of the kinds
of work they do is contained in these four new volumes of the Handbook. And the benefits
of their research are obvious to the scientific specialist who wants to learn even more
about food hazards, to the scientific generalist who is curious about everything and who
will be delighted to find a good source of accurate, up-to-date information, and to consum-
ers who care about what they eat.
We are confident that these four volumes will provide competent, trustworthy, and
timely information to inquiring readers, no matter what roles they may play in the global
campaign to achieve food safety.
Y. H. Hui
J. Richard Gorham
David Kitts
K. D. Murrell
Wai-Kit Nip
Merle D. Pierson
Syed A. Sattar
R. A. Smith
Peggy S. Stanfield
Preface
Much of the thought and action surrounding food safety deals with preventing foodborne
bacteria from causing disease—and that is as it should be. But there are other threats that
command our attention. These—the viruses and parasites—take center stage in the second
volume of the Foodborne Disease Handbook, Second Edition, Revised and Expanded.
Viruses play an important role as agents of human diseases, and indeed their relative
significance is increasing as we try to prevent and control the spread of common bacterial
pathogens. The potential for foodborne spread of viruses is also stronger now than ever
because of a combination of many current societal changes. Ongoing changes in demo-
graphics, changing lifestyles, faster and more frequent movement of peoples and goods,
and rapidly expanding global trade in produce have already had a profound impact on the
potential of viruses and other pathogens to spread through foods.
Eight chapters on foodborne viruses, contributed by internationally recognized ex-
perts in their respective fields, represent an overview of the most up-to-date information
in this area. They cover well-known viral pathogens, as well as those that are less well
understood but may acquire greater significance if left unheeded. The chapters, when
considered together, represent a valuable resource on the biology of foodborne viruses,
clinical diagnosis, and medical management as well as laboratory-based identification of
viral infections transmitted through foods, and the epidemiology, prevention, and control
of foodborne spread of viral pathogens. Wherever appropriate, the challenges and difficul-
ties of detecting viruses in foods are highlighted and research needs identified. The guide-
lines for reducing the risk of spread of hepatitis A through foods should be applicable to
many other foodborne pathogens.
It is anticipated that the information presented here will assist researchers, epidemi-
ologists, physicians, public health officials and government regulators, and those in the
food production and marketing business, to become better informed on the human health
impact of foodborne viral infections and to work collectively in making foods safer.
All chapters on parasites from the first edition have been revised and updated. The
addition of a chapter on the occurrence of parasites in seafood completes the overall sub-
ject of foodborne and waterborne diseases transmitted by parasites.
Although Americans are relatively unfamiliar with parasitic infection, three exam-
ples of areas in which diseases have been transmitted by parasites will help us to remember
v
vi Preface
this important subject: northern Taiwan (from consuming raw or undercooked beef), Asian
countries such as Thailand (undercooked pork), and Japan and Hawaii (undercooked sea-
food). Various chapters in this volume provide detailed description of these types of dis-
eases transmitted by parasites.
There is a gradual movement—sometimes voluntary, sometimes mandated—toward
implementation of HACCP principles in all aspects of the food industry, beginning with
production and harvesting and continuing through the various stages of manufacturing,
warehousing, wholesaling, retailing, and serving, until the food eventually reaches the
consumer's plate. However, for the moment, at least, it is in the area of food service that
the application of HACCP principles has reached the highest level of achievement. While
much remains to be done even in the food service sector with regard to the implementation
of HACCP, it will be seen from this second volume of the Foodborne Disease Handbook
that the mechanics of implementation have been worked out and fine-tuned, and that this
accomplishment may now serve as a model and a guide for other facets of the food in-
dustry.
The food industry in general seems to be buying into the HACCP system with an
apparent high level of commitment, and this bodes well for the consumer. But rather than
relaxing vigilance and trusting that HACCP will solve all food safety problems, the food
industry must heighten vigilance and redouble efforts to ensure that HACCP programs
are protected on all sides by a secure fortress of state-of-the-art environmental sanitation.
The editors and contributors to this volume have given researchers, microbiologists,
parasitologists, food-industry managers, food analysts, and HACCP managers a wealth
of information on how to detect and identify foodborne parasites and viral pathogens, how
to investigate the disease outbreaks they cause, and, most importantly, how to prevent
foodborne diseases by the practical application of HACCP principles.
Y. H. Hui
Syed A. Sattar
K. D. Murrell
Wai-Kit Nip
Peggy S. Stanfield
Contents
Introduction to the Handbook in

Preface v
Contributors ix
Contents of Other Volumes xi
I. Poison Centers
1. The Role of Poison Centers in the United States 1

II. Viruses
2. Hepatitis A and E Viruses 23

Theresa L. Cromeans, Michael O. Favorov, Omana V. Nainan, and
Harold S. Margolis
3. Norwalk Virus and the Small Round Viruses Causing Foodborne

Gastroenteritis 77
Hazel Appleton
4. Rotavirus 99
Syed A. Sattar, V. Susan Springthorpe, and Jason A. Tetro
5. Other Foodborne Viruses 127

Syed A. Sattar and Jason A. Tetro
6. Detection of Human Enteric Viruses in Foods 137

Lee-Ann Jaykus
vii
viii Contents
1. Medical Management of Foodborne Viral Gastroenteritis and Hepatitis 165

Suzanne M. Matsui and Ramsey C. Cheung
8. Epidemiology of Foodborne Viral Infections 183

Thomas M. Liithi
9. Environmental Considerations in Preventing the Foodborne Spread of

Hepatitis A 205
Syed A. Sattar and Sabah Bidawid
III. Parasites
10. Taeniasis and Cysticercosis 217

Zbigniew S. Pawlowski and K. D. Murrell
11. Meatborne Helminth Infections: Trichinellosis 229

William C. Campbell
12. Fish- and Invertebrate-Borne Helminths 249

John H. Cross
13. Waterborne and Foodborne Protozoa 289

Ronald Payer
14. Medical Management 323

Paul Prociv
15. Immunodiagnosis of Infections with Cestodes 347

Bruno Gottstein
16. Immunodiagnosis: Nematodes 375

H. Ray Gamble
17. Diagnosis of Toxoplasmosis 389

Alan M. Johnson and J. P. Dubey
18. Seafood Parasites: Prevention, Inspection, and HACCP 407

Ann M. Adams and Debra D. DeVlieger
IV. HACCP and the Foodservice Industries
19. Foodservice Operations: HACCP Principles 425

O. Peter Snyder, Jr.
20. Foodservice Operations: HACCP Control Programs 457

O. Peter Snyder, Jr.
Index 497
Contributors
Ann M. Adams Seafood Products Research Center, U.S. Food and Drug Administra-
tion, Bothell, Washington
Hazel Appleton Virus Reference Division, Public Health Laboratory Service, Central
Public Health Laboratory, London, England
Sabah Bidawid Food Directorate, Health Canada, Ottawa, Ontario, Canada
William C. Campbell Research Institute for Scientists Emeriti, Drew University, Madi-
son, New Jersey
Ramsey C. Cheung Department of Medicine (Gastroenterology), Stanford University

School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
Theresa L. Cromeans Hepatitis Branch, Division of Viral and Rickettsial Diseases,

National Center for Infectious Diseases, Centers for Disease Control and Prevention, At-
lanta, Georgia, and Department of Environmental Sciences and Engineering, School of
Public Health, University of North Carolina, Chapel Hill, North Carolina
John H. Cross Preventive Medicine and Biometrics, Uniformed Services University of

the Health Sciences, Bethesda, Maryland
Debra D. DeVlieger Division of Emergency and Investigational Operations, U.S. Food

and Drug Administration, Washington, D.C.
J. P. Dubey BARC, Parasite Biology and Epidemiology Laboratory, LPSI, Agricultural

Research Service, U.S. Department of Agriculture, Beltsville, Maryland
Michael O. Favorov Hepatitis Branch, Division of Viral and Rickettsial Diseases, Na-
tional Center of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta,
Georgia
Ronald Payer Agricultural Research Service, U.S. Department of Agriculture, Belts-

ville, Maryland
ix
x Contributors
H. Ray Gamble Parasite Biology and Epidemiology Laboratory, Agricultural Research

Service, U.S. Department of Agriculture, Beltsville, Maryland
Bruno Gottstein Institute of Parasitology, University of Berne, Berne, Switzerland
Y. H. Hui Science Technology System, West Sacramento, California
Lee-Ann Jaykus Department of Food Science, North Carolina State University, Ra-
leigh, North Carolina
Alan M. Johnson Professor of Microbiology, University of Technology, Sydney, New
South Wales, Australia
Thomas M. Liithi Official Food Control Authority of the Canton of Solothurn, Solo-
thurn, Switzerland
Harold S. Margolis Hepatitis Branch, Division of Viral and Rickettsial Diseases, Na-
tional Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta,
Georgia
Suzanne M. Matsui Department of Medicine (Gastroenterology), Stanford University
School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
K. D. Murrell Agricultural Research Service, U.S. Department of Agriculture, Belts-
ville, Maryland
Omana V. Nainan Hepatitis Branch, Division of Viral and Rickettsial Diseases, Na-
tional Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta,
Georgia
Zbigniew S. Pawlowski University of Medical Sciences, Poznan, Poland
Paul Prociv Department of Microbiology and Parasitology, The University of Queens-
land, Brisbane, Queensland, Australia
Syed A. Sattar Department of Biochemistry, Microbiology, and Immunology, Faculty
of Medicine, University of Ottawa, Ottawa, Ontario, Canada
O. Peter Snyder, Jr. Hospitality Institute of Technology and Management, St. Paul,
Minnesota
David G. Spoerke, Jr. Bristlecone Enterprises, Denver, Colorado
V. Susan Springthorpe Centre for Research on Environmental Microbiology, Depart-
ment of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University
of Ottawa, Ottawa, Ontario, Canada
Jason A. Tetro Centre for Research on Environmental Microbiology, Department of
Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa,
Ottawa, Ontario, Canada
Contents of Other Volumes
VOLUME 1: BACTERIAL PATHOGENS
I. Poison Centers
1. The Role of U.S. Poison Centers in Bacterial Exposures

II. Bacterial Pathogens
2. Bacterial Biota (Flora) in Foods

James M. Jay
3. Aeromonas hydrophila
Carlos Abeyta, Jr., Samuel A. Palumbo, and Gerard N. Stelma, Jr.
4. Update: Food Poisoning and Other Diseases Induced by Bacillus cereus

Kathleen T. Rajkowski and James L. Smith
5. Brucella
Shirley M. Hailing and Edward J. Young
6. Campylobacter jejuni
Don A. Franco and Charles E. Williams
1. Clostridium botulinum
John W. Austin and Karen L. Dodds
8. Clostridium perfringens
Dorothy M. Wrigley
XI
xii Contents of Other Volumes
9. Escherichia coli
Marguerite A. Neill, Phillip I. Tarr, David N. Taylor, and Marcia Wolf
10. Listeria monocytogenes

Catherine W. Donnelly
11. Bacteriology of Salmonella

Robin C. Anderson and Richard L. Ziprin
12. Salmonellosis in Animals

David J. Nisbet and Richard L. Ziprin
13. Human Salmonellosis: General Medical Aspects

Richard L. Ziprin and Michael H. Hume
14. Shigella
Anthony T. Maurelli and Keith A. Lampel
15. Staphylococcus aureus

Scott E. Martin, Eric R. Myers, and John J. landolo
16. Vibrio cholerae

Charles A. Kaysner and June H. Wetherington
17. Vibrio parahaemolyticus

Tuu-jyi Chai and John L. Pace
18. Vibrio vulnificus

Anders Dalsgaard, Lise H0i, Debi Linkous, and James D. Oliver
19. Yersinia
Scott A. Minnich, Michael J. Smith, Steven D. Weagant, and Peter Feng
III. Disease Surveillance, Investigation, and Indicator Organisms
20. Surveillance of Foodborne Disease

Ewen C. D. Todd
21. Investigating Foodborne Disease

Dale L. Morse, Guthrie S. Birkhead, and Jack J. Guzewich
22. Indicator Organisms in Foods

James M. Jay
Index
Contents of Other Volumes xiii
VOLUME 3: PLANT TOXICANTS
I. Poison Centers
1. U.S. Poison Centers for Exposures to Plant and Mushroom Toxins

II. Selected Plant Toxicants
2. Toxicology of Naturally Occurring Chemicals in Food

Ross C. Beier and Herbert N. Nigg
3. Poisonous Higher Plants

Doreen Grace Lang and R. A. Smith
4. Alkaloids
R. A. Smith
5. Antinutritional Factors Related to Proteins and Amino Acids

Irvin E. Liener
6. Glycosides
Walter Majak and Michael H. Benn
1. Analytical Methodology for Plant Toxicants

Alister David Muir
8. Medical Management and Plant Poisoning

Robert H. Poppenga
9. Plant Toxicants and Livestock: Prevention and Management

Michael H. Ralphs
III. Fungal Toxicants
10. Aspergillus
Zofia Kozakiewicz
11. Claviceps and Related Fungi

Gretchen A. Kuldau and Charles W. Bacon
12. Fusarium
Walter F. O. Marasas
13. Penicillium
John I. Pitt
xiv Contents of Other Volumes
14. Foodborne Disease and Mycotoxin Epidemiology

Sara Hale Henry and F. Xavier Bosch
15. Mycotoxicoses: The Effects of Interactions with Mycotoxins

Heather A. Koshinsky, Adrienne Woytowich, and George G. Khachatourians
16. Analytical Methodology for Mycotoxins

James K. Porter
17. Mycotoxin Analysis: Immunological Techniques

Fun S. Chu
18. Mushroom Biology: General Identification Features

19. Identification of Mushroom Poisoning (Mycetismus), Epidemiology,

and Medical Management
20. Fungi in Folk Medicine and Society

Index
VOLUME 4: SEAFOOD AND ENVIRONMENTAL TOXINS
I. Poison Centers
1. Seafood and Environmental Toxicant Exposures: The Role of

Poison Centers
II. Seafood Toxins
2. Fish Toxins
Bruce W. Halstead
3. Other Poisonous Marine Animals

Bruce W. Halstead
4. Shellfish Chemical Poisoning

Lyndon E. Llewellyn
5. Pathogens Transmitted by Seafood

Russell P. Herwig
Contents of Other Volumes xv
6. Laboratory Methodology for Shellfish Toxins

David Kitts
1. Ciguatera Fish Poisoning

Yoshitsugi Hokama and Joanne S. M. Yoshikawa-Ebesu
8. Tetrodotoxin
Joanne S. M. Yoshikawa-Ebesu, Yoshitsugi Hokama, and Tamao Noguchi
9. Epidemiology of Seafood Poisoning

Lora E. Fleming, Dolores Katz, Judy A. Bean, and Roberta Hammond
10. The Medical Management of Seafood Poisoning

Donna Glad Blythe, Eileen Hack, Giavanni Washington, and Lora E. Fleming
11. The U.S. National Shellfish Sanitation Program

Rebecca A. Reid and Timothy D. Durance
12. HACCP, Seafood, and the U.S. Food and Drug Administration
Kim R. Young, Miguel Rodrigues Kamat, and George Perry Hoskin
III. Environmental Toxins
13. Toxicology and Risk Assessment

Donald J. Ecobichon
14. Nutritional Toxicology

David Kitts
15. Food Additives

Laszlo P. Somogyi
16. Analysis of Aquatic Contaminants

Joe W. Kiceniuk
17. Agricultural Chemicals

Debra L. Browning and Carl K. Winter
18. Radioactivity in Food and Water

Hank Kocol
19. Food Irradiation

Hank Kocol
20. Drug Residues in Foods of Animal Origin

Austin R. Long and Jose E. Roybal
xvi Contents of Other Volumes
21. Migratory Chemicals from Food Containers and Preparation Utensils

Yvonne V. Yuan
22. Food and Hard Foreign Objects: A Review

/. Richard Gorham
23. Food, Filth, and Disease: A Review

J. Richard Gorham
24. Food Filth and Analytical Methodology: A Synopsis

J. Richard Gorham
Index
1
The Role of Poison Centers
in the United States

Bristlecone Enterprises, Denver, Colorado
I. Epidemiology 1
A. AAPCC 2
B. Poison center staff 3
C. Types of calls received 4
D. How calls are handled 5
E. What references are used 6
F. How poison centers are monitored for quality 7
G. Professional and public education programs 7
H. Related professional toxicology organizations 8
I. International AAPPC affiliations 9
J. Toxicology and poison center Web sites 10
II. U.S. Poison Information Centers 10
References 21
I. EPIDEMIOLOGY
Epidemiological studies aid treatment facilities in determining risk factors, determining

who becomes exposed, and establishing the probable outcomes with various treatments.
A few toxicology organizations have attempted to gather such information and organize
it into yearly reports. The American Association of Poison Control Centers (AAPCC) and
some federal agencies work toward obtaining epidemiological information, but the
AAPCC also has an active role in assisting with the treatment of potentially toxic expo-
sures. Epidemiological studies assist government and industry in determining package
safety, effective treatment measures, conditions of exposure, and frequency of exposure.
Studies on viral exposures provide information on the type of people most com-
monly involved in exposures. Are they children, adults at home, outdoorsmen, industrial
workers, or blue collar workers? Studies can also tell us which viral species are most
commonly involved. What symptoms are seen first, what the onset of symptoms is like,
and if there are any sequelae may also be determined and compared with current norms.
1
2 Spoerke
A. AAPCC
1. What Are Poison Centers and the AAPCC?
The group in the United States that is most concerned on a daily basis with potential
poisonings due to household agents, industrial agents, and biologies is the American Asso-
ciation of Poison Control Centers (AAPCC). This is an affiliation of local and regional
centers that provides information concerning all aspects of poisoning and refers patients
to treatment centers. This group of affiliated centers is often supported by local govern-
ment, private funds, and industrial sources.
Poison centers were started in the late 1950s; the first were in the Chicago area.
The idea caught on quickly and at the peak of the movement there were hundreds of
centers throughout the United States. Unfortunately, there were few or no standards as to
what might be called a poison center, the type of staff, hours of operation, or information
resources. One center may have had a dedicated staff of doctors, pharmacist, and nurses
trained specifically in handling poison cases; the next center may just have a book on
toxicology in the emergency room or hospital library. In 1993, the Health and Safety Code
(Section 777.002) specified that a poison center must provide a 24-hour service for public
and health care professionals and meet requirements established by the AAPCC. This
action helped the AAPCC to standardize activities and staffs of the various centers.
The federal government does not fund poison centers, even though for every dollar
spent on poison centers there is a savings of $2 to $9 in unnecessary medical expenses
(1,2). The federal agency responsible for the Poison Prevention Packaging Act is the U.S.
Consumer Product Safety Commission (CPSC). The National Clearinghouse for Poison
Control Centers initially collected data on poisonings and provided information on com-
mercial product ingredients and biologic toxic agents. For several years the National Clear-
inghouse provided product and treatment information to the poison centers that handled
the day-to-day calls.
At first, most poison centers were funded by the hospital in which they were located.
As the centers grew in size and number of calls handled, both city and state governments
look on the responsibility of contributing funds. In recent years the local governments
have found it difficult to fund such operations and centers have had to look to private
industry for additional funding. Government funding may take several forms, either as a
line item on a state budget, as a direct grant, or as moneys distributed on a per-call basis.
Some states with fewer residents may contract with a neighboring state to provide services
to its residents. Some states are so populous that more than one center is funded by the
state. Industrial funding also varies—sometimes as a grant, sometimes as payment for
handling the company's poison or drug information-related calls, sometimes as payment
for collection of data regarding exposure to the company's product.
Every year the AAPCC reports a summary of all kinds of exposures.
2. Regional Centers
As the cost of providing this service has risen, the number of listed centers has dropped
significantly since its peak of 600-plus. Many centers have been combined into regional
organizations. These regional poison centers provide poison information, offer telephone
management and consultation, collect pertinent data, and deliver professional and public
education. Cooperation between regional poison centers and poison treatment facilities is
crucial. The regional poison information center, assisted by local hospitals, should deter-
mine the capabilities of the treatment facilities of the region. They should also have a
Poison Centers and Viral Exposure 3
working relationship with their analytical toxicology, emergency and critical care, medical
transportation, and extracorporeal elimination services. This should be true for both adults
and children.
A "region" is usually determined by state authorities in conjunction with local
health agencies and health care providers. Documentation of these state designations must
be in writing unless a state chooses (in writing) not to designate any poison center or
accepts a designation by other political or health jurisdictions. Regional poison information
centers should serve a population base of greater than 1 million people and must receive
at least 10,000 human exposure calls per year.
The number of certified regional centers in the United States is now under 50. Certi-
fication as a regional center requires the following.
1. Maintenance of a 24 hour-per-day, 365-days-per-year service.
2. Provision of service to both health care professionals and the public.
3. Availability of at least one specialist in poison information in the center at all
times.
4. Having a medical director or qualified designee on call by telephone at all
times.
5. Service should be readily accessible by telephone from all areas in the region.
6. Comprehensive poison information resources and comprehensive toxicology
information covering both general and specific aspects of acute and chronic
poisoning should be available.
7. The center is required to have a list of on-call poison center specialty consul-
tants.
8. Written operational guidelines that provide a consistent approach to evaluation,
follow-up, and management of toxic exposures should be obtained and main-
tained. These guidelines must be approved in writing by the medical director
of the program.
9. There should be a staff of certified professionals manning the phones (at least
one of the individuals on the phone has to be a pharmacist or nurse with 2000
hours and 2000 cases of supervised experience)
10. There should be a 24 hour-per-day physician (board-certified) consultation ser-
vice.
11. The regional poison center shall have an ongoing quality assurance program.
12. Other criteria, determined by the AAPCC, may be established with member-
ship approval.
13. The regional poison information center must be an institutional member in
good standing of the AAPCC. Many hospital emergency rooms still maintain
a toxicology reference such as the POISINDEXS system to handle routine
exposure cases but rely on regional centers to handle most of the calls in their
area.
B. Poison Center Staff

The staffing of poison centers varies considerably from center to center. The three profes-
sional groups most often involved are physicians, nurses, and pharmacists. Who answers
the phones is somewhat dependent on the local labor pool, monies available, and the types
of calls being received. Others personnel used to answer the phone include students in
4 Spoerke
medically related fields, toxicologists, and biologists. Persons responsible for answering
the phones are either certified by the AAPCC or are in the process of obtaining certifica-
tion. Passage of an extensive examination on toxicology is required for initial certification,
with periodic recertification required.
Regardless of who takes the initial call, there is a medical director and other physi-
cian back-up available. These physicians have specialized training or experience in toxi-
cology, and are able to provide in-depth consultations for health care professionals calling
a center.
1. Medical Director
A poison center medical director should be board-certified in medical toxicology or be
board-certified in internal medicine, pediatrics, family medicine, or emergency medicine.
The medical director should be able to demonstrate ongoing interest and expertise in toxi-
cology as evidenced by publications, research, and meeting attendance. The medical direc-
tor must have a medical staff appointment at a comprehensive poison treatment facility
and be involved in the management of poisoned patients.
2. Managing Director
The managing director must be registered nurse, pharmacist, physician, or hold a degree
in a health science discipline. The individual should be certified by the American Board
of Medical Toxicology (for physicians) or by the American Board of Applied Toxicology
(for nonphysicians). He or she must be able to demonstrate ongoing interest and expertise
in toxicology.
3. Specialists in Poison Information
These individuals must be registered nurses, pharmacists, or physicians, or be currently
certified by the AAPCC as specialists in poison information. Specialists in poison informa-
tion must complete a training program approved by the medical director and must be
certified by the AAPCC as specialists in poison information within two examination ad-
ministrations of their initial eligibility. Specialists not currently certified by the Association
must spend an annual average of no fewer than 16 hours per week in poison center-related
activities. Specialists currently certified by the AAPCC must spend an annual average of
no less than 8 hours per week. Other poison information providers must have sufficient
background to understand and interpret standard poison information resources and to trans-
mit that information understandably to both health professionals and the public.
4. Consultants
In addition to physicians specializing in toxicology, most centers also have lists of experts
in many other fields as well. Poison center specialty consultants should be qualified by
training or experience to provide sophisticated toxicology or patient care information in
their area(s) of expertise. In regard to viral exposures, the names and phone numbers of
persons in infectious disease at nearby hospitals might be helpful. Funding is usually a
crucial issue, so these experts should be willing to donate their expertise in identification
and handling cases within their specialty. Poison centers usually do not have specific
specialists in viral diseases. Local hospital departments are most often contacted and the
patient referred to the specialist.
C. What Types of Calls Are Received?

All types of calls are received by poison centers, most of which are handled immediately
while others are referred to more appropriate agencies. Which calls are referred depends
on the center, its expertise, its consultants, and the appropriateness of a referral. Below
are lists of calls that generally fall into each group. Remember there is considerable varia-
tion between poison centers; if there is doubt, call the poison center and they will tell you
if your case is more appropriately referred. Poison centers do best on calls regarding acute
exposures. Complicated calls regarding exposure to several agents over a long period of
time, which produces nonspecific symptoms, are often referred to another medical special-
ist, to the toxicologist associated with the center, or to an appropriate government agency.
The poison center will often follow up on these cases to track outcome and type of service
given.
Types of Calls Usually Accepted
Drug identification
Actual acute exposure to a drug or chemical
Actual acute exposure to a biologic agent (e.g., plants, mushrooms, various ani-
mals)
Information regarding the toxic potential of an agent
Possible food poisonings
Types of Calls Often Referred
Questions regarding treatment of a medical condition (not poisoning)
Questions on common bacterial, viral, or parasitic infections
General psychiatric questions
Proper disposal of household agents such as batteries, bleach, insecticides
Use of insecticides (which insecticide to use, how to use it) unless related to a
health issue, e.g., a person allergic to pyrethrins wanting to know which prod-
uct does not contain pyrethrins)
Records of all calls/cases handled by the center should be kept in a form that is
acceptable as a medical record. The regional poison information center should submit all
its human exposure data to the Association's National Data Collection System. The re-
gional poison information center shall tabulate its experience for regional program evalua-
tion on at least an annual basis.
1. AAPCC Toxic Exposure Surveillance System
In 1983 the AAPCC formed the Toxic Exposure Surveillance System (TESS) from the
former National Data Collection System. Currently, TESS contains nearly 16.2 million
human poison exposure cases. Sixty-five poison centers, representing 181.3 million peo-
ple, participate in the data collection. The information has various uses to both governmen-
tal agencies and industry, providing data for product reformulations, repackaging, recalls,
bans, injury potential, and epidemiology.
The summation of each year's surveillance is published in the American Journal of
Emergency Medicine late each summer or fall.
D. How Calls Are Handled

Most poison centers receive requests for information via the telephone. Calls come from
both health care professionals and consumers. Only a few requests are received by mail
or in person, and these are often medicolegal or complex cases. Most centers can be
reached by a toll-free phone number in the areas they serve, as well as a local number.
6 Spoerke
Busy centers will have a single number that will ring on several lines. Calls are often
direct referrals from the 911 system. In most cases, poison center specialists are unable
to determine the virus involved, so the caller is referred to a infectious disease physician.
Poison information specialists listen to the caller, recording the history of the case
on a standardized form developed by AAPCC. Basic information such as the agent in-
volved, amount ingested, time of ingestion, symptoms, previous treatment, and current
condition are recorded, as well as patient information such as sex, age, phone number,
who is with the patient, relevant medical history, and sometimes patient address. All infor-
mation is considered a medical record and is therefore confidential.
The case is evaluated (using various references) as:
1. Information only, no patient involved

2. Harmless and not requiring follow-up
3. Slightly toxic, no treatment necessary but a follow-up call is given
4. Potentially toxic, treatment given at home and follow-up given to case resolution
5. Potentially toxic, treatment may or may not be given at home, but it is necessary
for the patient to be referred to a medical facility
6. Emergency—an ambulance and/or paramedics are dispatched to the scene
Cases are usually followed until symptoms have resolved. In cases where the patient
is referred to a health care facility, the hospital is notified, the history relayed, toxic poten-
tial discussed, and suggestions for treatment given.
E. What References Are Used?

References used also vary from center to center, but virtually all centers use a toxicology
system called POISINDEX8, which contains lists of products, their ingredients, and sug-
gestions for treatment. The system is compiled using medical literature and editors
throughout the world. Biologic products such as plants, insects, mushrooms, animal bites,
and so forth are handled similarly. Viral infections are not listed in the system. An entry
for an individual household product or plant might contain a description, potentially toxic
agent, potential toxic amounts, and so forth. The physician or poison information specialist
is then referred to a treatment protocol that may apply to a general class of agents. Using
plants as an example, an exposure to a philodendron would be referred to a protocol on
oxalate-containing plants. An unknown skin irritation or potential infection would deserve
a consult with an infectious disease specialist. POISINDEX is available on microfiche, a
CD-ROM, over a network, or on a mainframe. It is updated every 3 months.
Various texts are also used, especially when the exposure agents, like viruses, are
usually not in POISINDEX. It is very difficult to identify infectious cases over the phone,
so often the assistance of an epidemiologist and an infectious disease specialist is used.
Some poison centers have more experience with certain types of poisonings, so often one
center will consult another on an interesting case. These are often more complex cases,
or cases involving areas within both centers' regions.
A recent trend has been for various manufacturers not to provide product information
to all centers via POISINDEX but to contract with one poison center to provide for poison
information services for the whole country. Product information is given to only that center
and cases throughout the country are referred to that one center.
F. How Poison Centers Are Monitored for Quality

Most poison centers have a system of peer review in place. One person takes a call,
another reviews it. Periodic spot review is done by supervisor and physician staff. General
competence is assured by certification and recertification via examination of physicians
and poison information specialists. The review process helps the poison control specialists
to be consistent.
G. Professional and Public Education Programs

The regional poison information center is required to provide information on the manage-
ment of poisoning to the health professionals throughout the region who care for poisoned
patients. Public education programs aimed at educating both children and adults about
poisoning concerns and dangers should be provided.
In the past, several centers provided stickers or logos such as Officer Ugh, Safety
Sadie, and Mr. Yuck that could be placed on or near potentially toxic substances. While
the intent was to identify potentially toxic substances from which children should keep
away, the practice has been much curtailed on the new assumption that in some cases the
stickers actually attracted the children to the products.
In the spring of every year there is a poison prevention week. National attention is
focused on the problem of potentially toxic exposures. During this week many centers
run special programs for the public. This may include lectures on prevention, potentially
toxic agents in the home, potentially toxic biologic agents, or general first-aid methods
using during a poisoning. Although an important time for poison centers, public and pro-
fessional education is a year-round commitment. Physicians are involved with medical
toxicology rounds, journal clubs, and lectures by specialty consultants. Health fairs, school
programs, and various men's and women's clubs are used to educate the public. The extent
of these activities is often determined by the amount of funding from government, private
organizations, and public donations.
H. Related Professional Toxicology Organizations

ACGIH American Conference of Governmental and Industrial Hygienists
Address: Kemper Woods Center, Cincinnati, OH, 45240
Phone: 513-742-2020
FAX: 513-742-3355
ABAT American Board of Applied Toxicology
Address: Truman Medical Center, West, 2301 Holmes St., Kansas City, MO,
64108
Phone: 816-556-3112
FAX: 816-881-6282
AACT American Association of Clinical Toxicologists
Address: c/o Medical Toxicology Consultants, Four Columbia Drive, Suite
810, Tampa FL, 33606
AAPCC American Association of Poison Control Centers
Address: 3201 New Mexico Avenue NW, Washington, DC, 20016
Phone: 202-362-7217
FAX: 202-362-8377
Spoerke
ABEM American Board of Emergency Medicine

Address: 300 Coolidge Road, East Lansing, MI, 48823
Phone: 517-332-4800
FAX: 517-332-2234
ACEP American College of Emergency Physicians (Toxicology Section)
Address: P.O. Box 619911, Dallas, TX, 75261-9911
Phone: 800-798-1822
FAX: 214-580-2816
ACMT American College of Medical Toxicology (formerly ABMT)
Address: 777 E. Park Drive, P.O. Box 8820, Harrisburg, PA, 17105-8820
Phone: 717-558-7846
FAX: 717-558-7841E-mail: lkoval@pamedsoc.org (Linda L. Koval)
ACOEM American College of Occupational and Environmental Medicine
Address: 55 West Seegers Road, Arlington Heights, IL, 60005
Phone: 708-228-6850
FAX: 708-228-1856
ACS Association of Clinical Scientists, Dept. of Laboratory Medicine, University
of Connecticut Medical School
Address: 263 Farmington Ave., Farmington, CT, 06030-2225
Phone: 203-679-2328
FAX: 203-679-2328
ACT American College of Toxicology
Address: 9650 Rockville Pike, Bethesda, MD, 20814
Phone: 301-571-1840
FAX: 301-571-1852
AOEC Association of Occupational and Environmental Clinics
Address: 1010 Vermont Ave., NW, #513, Washington, DC, 20005
Phone: 202-347-4976
FAX: 202-347-4950
E-mail: Io478x@gwis.circ.gwu.edu
ASCEPT Australian Society of Clinical and Experimental Pharmacologists and
Toxicologists
Address: 145 Macquarie St., Sydney N.S.W. 2000, Australia
Phone: 61-2-256-5456
FAX: 61-2-252-3310
BTS British Toxicology Society, MJ Tucker, Zeneca Pharmaceuticals
Address: 22B11 Mareside; Alderley Park, Macclesfield, Cheshire, SklO 4TG,
United Kingdom
Phone: 0428 65 5041
CAPCC Canadian Association of Poison Control Centers, Hopital Sainte-Justine
Address: 3175 Cote Sainte-Catherine; Montreal, Quebec, H3T1C5
Phone: 514-345-4675
FAX: 514-345-4822
CSVVA (CEVAP) Center for the Study of Venoms and Venomous Animals
Address: UNESP, Alameda Santos, N 647, CEP 01419-901, Sao Paulo, SP;
Brazil
Phone: 55011 2520233
FAX: 55011 2520200
EAPCCT European Association of Poison Control Centers

Address: J. Vale, National Poisons Information Centre, P.O. Box 81898 Dep;
N-0034 Oslo, Norway
Phone: 47-260-8460
HPS Hungarian Pharmacological Society, Central Research Institute for
Chemistry
Address: Hungarian Academy of Sciences, H-1525 Budapest, P.O. Box 17,
Pusztaszeri ut 59-67
Phone: 36-1-135-2112
ISOMT International Society of Occupational Medicine and Toxicology
Address: USC School of Medicine, 222 Oceanview Ave., Suite 100, Los
Angeles, CA, 90057
Phone: 213-365-4000
JSTS Japanese Society of Toxicological Sciences
Address: Gakkai Center Building, 4-16, Yayoi 2-chome, Bunkyo-ku, Tokyo
113, Japan
Phone: 3-3812-3093
FAX: 3-3812-3552
SOT Society of Toxicology
Address: 1101 14th Street, Suite 1100, Washington, DC., 20005-5601
Phone: 202-371-1393
FAX: 202-371-1090
E-mail: sothq@toxicology.org
SOTC Society of Toxicology of Canada
Address: P.O. Box 517, Beaconsfield, Quebec, H9W 5V1, Canada
Phone: 514-428-2676
FAX: 514-482-8648
STP Society of Toxicologic Pathologists
Address: 875 Kings Highway, Suite 200, Woodbury, NJ, 08096-3172
Phone: 609-845-7220
FAX: 609-853-0411
SSPT Swiss Society of Pharmacology and Toxicology
Address: Peter Donatsch, Sandoz Pharma AG, Toxicologtie 881/130, CH-
4132 Muttenz, Switzerland
Phone: 41-61-469-5371
FAX: 41-61-469-6565
WFCT World Federation of Associations of Clinical Toxicology Centers and Poi-
son Control Centers
Address: Centre Anti-Poisons, Hopital Edonard Herriot, 5 pi d, Arsonval,
69003 Lyon, France
Phone: 33 72 54 80 22
FAX: 33 72 34 55 67
I. International AAPPC Affiliations

The AAPCC and its members attend various world conferences to learn of toxicology
problems and new methods used by these agencies. An especially close relationship has
formed between the American and Canadian poison center associations. Once a year the
10 Spoerke
AAPCC and CAPCC hold a joint scientific meeting and invite speakers and other toxicol-
ogy specialists from around the world. Some international affiliated organizations are listed
with the North American groups above.
J. Toxicology and Poison Center Web sites

Association of Occupational and Environmental Clinics This group is dedi-
cated to higher standards of patient-centered, multidisciplinary care emphasiz-
ing prevention and total health through information sharing, quality service,
and collaborative research.
Address: Io478x@gwis.circ.gwu.edu
Finger Lakes Regional Poison Center
Address: pwax@ed.urmc.rochester.edu
Medical/Clinical/Occupational Toxicology Professional Groups A list of pri-
marily U.S. professional groups interested in toxicology. There is a description
of each group, the address, phone numbers, and contact names.
Keyword: poison centers, toxicology
Address: http: //www.pitt.edu/~martint/pages/motoxorg.htm
Poison Net A mailing list dedicated to sharing information, problem solving, and
networking in the areas of poisoning, poison control centers, hazardous materi-
als, and related topics. The list is intended for health care professionals, not
the lay public. The moderators do not encourage responses to individual poi-
soning cases from the public:
Keyword(s): poisoning, poison control centers
II. U.S. POISON INFORMATION CENTERS
The following poison control center telephone numbers and addresses are thought to be
accurate as of the date of publication. Poison control center telephone numbers or ad-
dresses may change. The address and phone number of the poison control center nearest
you should be checked frequently. If the number listed does not reach the poison center,
contact the nearest emergency service, such as 911 or local hospital emergency rooms.
The authors disclaims any liability resulting from or relating to any inaccuracies or changes
in the phone numbers provided below. An asterisk indicates a regional center designated
by the American Association of Poison Control Centers. This information should NOT
be used as a substitute for seeking professional medical diagnosis, treatment, and care.
ALABAMA Tuscaloosa
Alabama Poison Control System, Inc.
Birmingham 408 A Paul Bryant Drive, East
Regional Poison Control Center* Tuscaloosa, AL 35401
Children's Hospital of Alabama (800) 462-0800 (AL only)
1600 Seventh Avenue, South Birmingham, (205) 345-0600
AL 35233-1711
(800) 292-6678 (AL only)
(205) 933-4050
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[281] Place, Ninive, vol. i. p. 58.
[282] Botta, Monument de Ninive, plate 113.
[283] Ibid. plates 43 and 53.
[284] Botta, Monument, &c. plate 62.
[285] Ibid. plates 61 and 76, and vol. v. p. 124.
[286] See especially at the south end of the Nimroud Gallery,
the upper part of a male figure, numbered 17 a. The black of the
hair and beard has preserved much of its strength.
[287] “At Kouyunjik there were no traces whatever of colour.”
Nineveh, vol. ii. p. 310.
[288] Heuzey, Catalogue des Figurines en terre cuite du
Musée du Louvre, p. 18.
[289] Heuzey, Catalogue, &c. p. 19.
[290] Ibid. p. 20. Layard also found many of these blue
statuettes at Khorsabad (Discoveries, p. 357).
[291] These fragments were found by Layard in one of the
small temples at Nimroud (Discoveries, pp. 357, 358).
[292] M. Sully Prudhomme has lately embodied this idea in
his verses addressed to the Venus of the Louvre (Devant la
Vénus de Milo in the Revue politique for 6 January, 1883):—
“Dans les lignes du marbre où plus rien ne subsiste

De l’éphémère éclat des modèles de chair,
Le ciseau de sculpteur, incorruptible artiste,
En isolant le Beau, nous le rend chaste et clair.
Si tendre à voir que soit la couleur d’un sein rose,

C’est dans le contour seul, presque immatériel,
Que le souffle divin se relève et dépose
La grâce qui l’exprime et ravit l’âme au ciel.
* * * * *
Saluons donc cet art qui, trop haut pour la foule.

Abandonne des corps les éléments charnels.
Et, pur, du genre humain ne garde que le moule,
N’en daigne consacrer que les traits éternels!
[293] Herodotus, i. 195. Strabo says the same thing, but in
a passage (xvi. i. 20), in which he borrows from Herodotus
without acknowledgment.
[294] There are fine series of these seals, or cylinders, both in
the Louvre and in the Cabinet des Antiques of the French
National Library. But the collection of the British Museum is the
richest of all. It possesses about 660 examples, against the 500
of the Cabinet des Antiquités, and the 300 of the Louvre. The
cabinet at the Hague has 150. A single French collector, M. de
Clercq, possesses more than 400, most of them in very fine
condition and of great interest. He is preparing to publish a
descriptive catalogue of his treasures, accompanied by
photogravure facsimiles of every cylinder. According to M.
Ménant, the total number of these cylinders now in European
galleries can fall very little short of three thousand.
[295] M. Fr. Lenormant explains this talismanic value of the
cylinders very clearly in his Étude sur la Signification des Sujets
de quelques Cylindres babyloniens et assyriens (Gazette
archéologique, 1879, p. 249).
[296] We have derived most of the information contained in
this chapter from the works of M. Ménant, who, for many years
past has given more study to these cylinders than any other
savant. We have found his Essai sur les Pierres gravées de l’Asie
occidentale of special value, but we have also made use of the
various reports he has published in the Archives des Missions,
relating to the foreign collections visited by him, and of his papers
read before the Académie des Inscriptions. We have, moreover,
consulted the following works, not, we hope, without profit: De
Gobineau, Catalogue d’une Collection d’Intailles asiatiques
(Revue archéologique, new series, vol. xxvii.); E. Soldi, Les
Cylindres babyloniens, leur Usage et leur Classification (ibid. vol.
xxviii.); and Les Arts méconnus, by the same author (1 vol. 8vo.
Leroux, 1881), chapter i., Les Camées et les Pierres gravées.
[297] The thickest cylinders are found among those that
appear the most ancient. I measured one, in the Cabinet des
Antiquités, that was barely less than an inch in diameter. On the
other hand, there are some very small ones in existence.
[298] Ménant, Essai sur les Pierres gravées de l’Asie
occidentale, Introduction, p. 19. In the British Museum M. Ménant
made a careful examination of a tablet on which these successive
impressions from a cylinder allowed the whole of the scene with
which it was engraved to be studied (Rapport sur les Cylindres
Assyro-Chaldéens du Musée britannique, p. 95, in the Archives
des Missions scientifiques, 1879). Even as late as 1854, a fine
connoisseur like De Longperier could think that the cylinders
were purely amulets and were never used as seals (Notice des
Antiquités assyriennes exposées dans les Galeries du Louvre,
3rd edition, p. 87). No such assertion could be made now.
Hundreds of impressions are to be found on the terra-cotta tablets
from Mesopotamia, and moreover, we find this formula in the
inscription borne by many of the cylinders: “Seal (kunuku) of so-
and-so, son of so-and-so.” In Assyrian the word kunuku meant, as
the word seal with us, both the instrument used and the
impression it gave (Ménant, Essai, Introduction, p. 17). Some of
these impressions are figured in Layard, Discoveries, chapters vi
and xxv. See also his Monuments, second series, plate 69.
[299] The Louvre possesses a cylinder mounted in this
fashion. It was found by Place in the foundations of the
Khorsabad palace. See De Longperier, Notice, p. 98, (No. 469
in the Catalogue).
[300] Taylor, Notes on the Ruins of Mugeyer, p. 270 (in the
Journal of the Royal Asiatic Society, vol. xv.).
[301] Layard, Discoveries, p. 563.
[302] A few cylinders of fine stone dating apparently from the
early monarchy, are exceptions to this rule. M. Ménant quotes a
cylinder of sapphirine chalcedony, which he ascribes to the reign
of Dungi, the son of Ourkam (Essai sur les Pierres gravées, pp.
141–143); elsewhere he mentions an onyx cylinder in the Cabinet
des Antiques (No. 870), which bears an inscription proving it to
have been the seal of the scribe or secretary who served the son
of Karigalzu, whom he places at the end of the fifteenth century
b.c. We also find jasper cylinders that appear, so far as their
execution and the costume of the figures engraved on them may
show, to have come from the same workshops (ibid. p. 123) as
those of the softer materials. This, we acknowledge, is a difficulty.
But in the first place they may have now and then succeeded,
even in the early years of the art, in fashioning materials harder
than those with which they were familiar, by redoubling the
patience and time spent upon the work; and, secondly, several
kings separated from each other by centuries must have borne
the same name, and it is perhaps a little bold to determine the
age of a monument from the fact that it is engraved with this or
that royal name. Who can say that none of these little monuments
were reworked in the time of Nebuchadnezzar? Archaism was
then in fashion. The writing of the early monarchy was imitated in
official documents. Is it not probable enough that, while they were
in the vein, they copied the seals of the old and almost legendary
kings? They would reproduce them in their entirety, both images
and texts, but in obedience to the taste of the day, they would
execute the copies in those harder and more precious materials
which his increased skill permitted the workman to attack. In spite
of a few doubtful instances, we may repeat the general rule we
have laid down: That the great majority of those cylinders that
bear incontestable marks of a high antiquity, are cut from
materials inferior in hardness to the precious stones, or even to
the quartzes.
[303] E. Soldi, Les Cylindres babyloniens (Revue
archéologique, vol. xxviii. p. 147).
[304] Ibid. p. 149.
[305] The three pages in which M. Soldi sums up the result of
his inquiries, may be studied with advantage (Les Arts méconnus,
pp. 62–64).
[306] See J. Ménant, Observations sur trois Cylindres
orientaux (Gazette des Beaux-Arts, December, 1879).
[307] Or, more correctly, Dioscurides (Διοσκουρίδης),
according to the texts.—Ed.
[308] As to the connection of the Greek Heracles with Izdubar,
see a passage quoted from Sayce by Mansell (Gazette
archéologique, 1879, pp. 116, 117?). The New York cylinder is
only 1.52 inches high. It has been slightly enlarged in our
woodcut, so that its workmanship might be better shown.
[309] Upon the exploits of these two individuals, and the place
they occupy upon the cylinders, see Ménant, Essai, &c., pp. 66,
et seq.
[310] Ménant, Essai sur les Pierres gravées, Fig. 86.
[311] Ibid. p. 138.
[312] De Longpérier, Œuvres, vol. i. p. 335. Compare our
Fig. 17, Vol. i., and M. Ménant’s observations upon the double-
faced individual in whom the original androgynous type of the
human race has been recognised by some (Essai, &c., pp. 111–
120). We are inclined to agree with him in supposing the double
profile to be no more than a convention, whose strangeness is
diminished when we remember that it occurred upon the convex
sides of a cylinder, where the eye of the spectator did not grasp it
all at once, as upon the flat impression. In choosing such an
arrangement, the artist seems to have desired to connect the
figure both with the seated god and the figures on the other side;
it is an expedient of the same nature as the five legs of the
Ninevite bulls.
[313] Ménant, Essai, &c., p. 166. M. Ménant mentions some
other myths, with which this scene may be connected. The true
explanation cannot be decided, however, until the Chaldee
mythology is better known than at present.
[314] Ibid. p. 153.
[315] Art in Ancient Egypt, Vol. i. Fig. 85.
[316] Ménant, Essai, &c., pp. 61–96.
[317] Ménant, Essai, p. 94. Izdubar contends not only with
monsters; he pursues, for his own pleasure, all the beasts of the
desert and mountain; like the Nimrod of Genesis, he is a “mighty
hunter before the Lord.” See the cylinders figured and explained
by S. Haffner (La Chasse de l’Hercule assyrien, in the Gazette
archéologique, 1879, p. 178–184).
[318] Ménant, Essai, p. 91.
[319] See above, page 144, and Fig. 70.
[320] Ménant, Essai, pp. 55–62.
[321] Berosus, fragment 1, § 4, in vol. ii. of the Fragmenta
historicorum Græcorum of Ch. Müller.
[322] Botta, Monument de Ninive, vol. v. p. 2. Layard,
Discoveries, p. 605.
[323] These two cylinders are respectively numbered 937 and
942 in the Cabinet des Antiques.
[324] Ménant, Catalogue des Cylindres orientaux du Cabinet
royal des Médailles de La Haye (The Hague, 4to.), No. 135.
[325] Upon these types see Ménant, Archives des Missions,
1879, pp. 128–9. The signet figured above belonged to a member
of the tribe called Egibi, a group of merchants and bankers who
seem to have held the highest rank upon the market of Babylon,
both under the last national kings, and under the Achæmenidæ.
[326] Archives des Missions, 1879, p. 115.
[327] The charging animal seems rather to be a wild boar. The
shape of its head and body, the ridge of hair along the spine, the
shape of the legs and feet, and its action in charging, all suggest
a boar, a suggestion confirmed by the action of the hunter, who
receives the rush of the animal on a kind of scarf or cloak, while
he buries his boar-spear in its back.—Ed.
[328] The cylinder published by Layard, Introduction à l’Étude
du Culte public et des Mystères de Mithra, plate xxv. No. 4. See
on the subject of the inscription upon it, Levy, Siegel und
Gemmen, plate 1, No. 15. A certain number of intaglios with
Aramaic characters, which belong to the same class, have been
studied and described by M. de Vogué, in his Mélanges
d’Archéologie orientale, pp. 120–130.
[329] National Library, Paris; No. 1086.
[330] National Library, No. 978.
[331] Ménant, Empreintes de Cachets assyro-chaldéens
relevées au Musée britannique (Archives des Missions, 1882, p.
375), fig. 5.
[332] Ibid. fig. 25.
[333] A kneeling figure occurs on a contract dated from the
seventh century, Ménant, ibid. p. 376, fig. 7. Several impressions
in the London collection show us personages in the modern
attitude of prayer before the figure of a god overshadowed by
huge wings. Ibid. figs. 26 and 27.
[334] Ménant, Empreinte de Cachets, &c. fig. 65.
[335] De Luynes collection, No. 188. Diameter 1 inch.
[336] No. 986.
[337] Ibid. figs. 20–24, 27, 30, 31, 41–44.
[338] Art in Ancient Egypt, vol. ii. pp. 290, 291.
[339] Ménant, Rapport sur les Cylindres du Musée
britannique, p. 127.
[340] Soldi, Les Cylindres babyloniens (Revue archéologique,
vol. xxviii.), p. 153.
[341] Art in Ancient Egypt, vol. i. fig. 85.
[342] Layard, Discoveries, p. 281. A scarab of Amenophis III.
has also been found. Layard also tells us that he found several
scarabæi of Egyptian manufacture, while excavating at Nimroud,
and others were brought to him which had been found in different
parts of Mesopotamia.
[343] Account of the income and expenditure of the British
Museum for 1878.
[344] In a recently published work (Kritik des Ægyptischen
Ornaments, archäologische Studie, with two lithographic plates,
Marburg, 8vo, 1883) Herr Ludwig von Sybel has investigated the
influence exercised by what he calls Asiatic ornament upon
Egyptian art, after the commencement of the second Theban
empire. The impression left by his inquiry—which is conducted
with much order and critical acumen—is that Egypt, by the
intermediary of the Phœnicians, received more from Assyria and
Chaldæa than she gave. This influence was exercised chiefly by
the numerous metal objects imported into the Nile valley from
western Asia, where metallurgy was more advanced and more
active than in Egypt. We may have doubts as to some of Herr von
Sybel’s comparisons, and may think he sometimes exaggerates
the Asiatic influence, but none the less may his work be read both
with profit and interest.
[345] See above, page 98.
[346] Layard, Monuments, first series, plate 7.
[347] Art in Ancient Egypt, vol. ii. chapter iv. § 1.
[348] Vol. I. Chapter II. § 7.
[349] The ornament reproduced in our Plate XIII. is borrowed
from a plate of Layard’s Monuments (first series, plate 80), and
the two subjects brought together in Plate XIV. are taken from
plate 55 of the second series. Our Plate XV. brings together, on a
smaller scale, the figures which occupy plates 29, 30 and 31 of
Place’s Ninive.
[350] Layard, Nineveh, vol. ii. p. 311.
[351] Place, Ninive, plate 32.
[352] Layard, Discoveries, p. 166, note.
[353] Place, Ninive, vol. ii. pp. 251, 252.
[354] Lepsius, Les Métaux dans les Inscriptions egyptiennes.
Translated into French by W. Berend, and with additions by the
author, 1877.
[356] Ibid. p. 166.
[357] Layard, Nineveh, vol. ii. p. 313.
[359] Place, Ninive, vol. ii. p. 252.
[360] Diodorus, ii. viii. 4.
[361] Rawlinson, The Five Great Monarchies, vol. i. pp. 91,
92. We borrow figs. 163–8 from Professor Rawlinson. Some of
these, he tells us, are from drawings by Mr. Churchill, the artist
who accompanied Loftus into Chaldæa and Susiana; the rest are
taken from objects now in the British Museum.
[362] We borrow the figures numbered 183, 184, 186 and 187,
from the plate accompanying a remarkable paper by M. Helbig,
in which he points out the similarities that exist between this
Ninevite pottery, and the oldest pottery of Attica and the Ægæan
islands (Osservazioni sopra la provenienza della decorazione
geometrica, in the Annales de l’Institut de Correspondance
archéologique, 1875, p. 221). The tracings reproduced by M.
Helbig (tavola d’aggiunta, H), were made by Mr. Murray. Our
figures 182, 185, and 188 were taken from drawings made by
myself in the British Museum.
[364] Birch, History of Ancient Pottery, 2nd edition, 1873, p.
91.
[365] Birch, History of Ancient Pottery, 2nd edition, 1873, p.
104.
[366] The British Museum possesses some fine examples of
these coffins; they were transported to England by Loftus, who
had some difficulty in bringing them home intact. See Loftus,
Travels and Researches, &c., p. 204; Layard, Discoveries, pp.
558–561; and Birch, History of Ancient Pottery, pp. 105–107. In
the upper parts of the mounds at Warka and Niffer, where these
slipper-shaped coffins were packed in thousands, fragments of
glazed earthenware, plates and vases, were also found; they
seemed to date from the same period.
[367] Art in Ancient Egypt, vol. ii. p. 375.
[368] Botta, Monument de Ninive, vol. v. p. 173. Rawlinson,
The Five Great Monarchies, vol. i. pp. 389–391.
[369] On this subject see a note by Sir David Brewster (?),
appended to Layard, Discoveries, pp. 674–676.
[371] Layard, Nineveh, vol. i. p. 421; Discoveries, p. 197.
[372] Rawlinson, The Five Great Monarchies, vol. i. p. 574.
[373] A detailed description of this curious object will be found
in a note supplied to Layard by Sir David Brewster, who made a
careful examination of the lens (Discoveries, p. 197).
[374] See Rawlinson, The Five Great Monarchies, &c., vol. i.
pp. 95–97.
[375] On the richness of the metalliferous deposits about the
head-waters of the Tigris and Euphrates, see vol. i. pp. 124, 125.
[377] Ibid.
[378] Ibid.
[380] Art in Ancient Egypt, vol. ii. pp. 303–305 and 379.
[381] Place, Ninive, vol. i. pp. 84–89, and plates 70, 71.
[382] A certain number of iron implements are exhibited in the
British Museum (Kouyundjik Gallery, case e); they were found for
the most part at Nimroud, by Sir H. Layard (Discoveries, pp. 174
and 194). Among objects particularly mentioned by him are feet of
chairs, tables, &c., mattocks and hammers, the heads of arrows
and lances, and a double-handled saw 62 inches long.
[383] Place, Ninive, vol. i. p. 264 and plate 71; figs. 5, 6 and
7.
[384] This is formally stated by Dr. Percy, who furnished
Layard with a long note upon the composition of the Assyrian
bronzes (Discoveries, p. 670). At Nimroud, the latter found
helmets and cuirasses of iron with surface ornaments of bronze
(Nineveh, vol. i. p. 341). He speaks of this proceeding as
characteristic of Assyrian metal-work (Discoveries, p. 191).
[385] To the evidence of Layard, which we have already had
occasion to quote on this point, we may add that of Rich
(Kurdistan, vol. i. pp. 176 and 222).
[386] Layard, Discoveries, chapter viii.
[387] See Dr. Percy’s note, at the end of the Discoveries, p.
670.
[388] Layard, Discoveries, pp. 176–178.
[389] Nahum, ii. 9.
[390] E. Flandin, Voyage archéologique.
[391] Layard, Discoveries, pp. 198, 199.
[392] In 1882 these fragments were in the Nimroud central
saloon. In the Assyrian side room, close to the door, there is
another throne whose bronze casing might be restored almost in
its entirety. Its decoration is less rich, however, than that of the
thrones of which we have been speaking. A poor drawing of it
may be found in George Smith’s Assyrian Discoveries, p. 432.
[393] This is not complete; about a third of it seems to be
missing.
[394] Reasoning from the analogy of the ivories above
mentioned, it might be thought that this fragmentary column
belonged to the balustrade of a window. M. Dieulafoy, who first
drew our attention to the fragment, provided us with a photograph
of it, and is of that opinion.
[395] In Botta, Monument de Ninive, plate 164, a bronze
bull’s head is figured which must have been used as the arm of a
chair.
[396] This motive was by no means rare. Some more
examples will be found reproduced in Layard, Nineveh, vol. ii. p.
301. At Malthaï there are human figures between the uprights of
the throne on which the second deity is seated. They may be
seen more clearly in Place’s large plate (No. 45), than in our
necessarily small engraving.
[397] 1 Kings x. 18.
[398] Layard, Discoveries, p. 198; Smith, Assyrian
Discoveries, pp. 431, 432.
[399] George Smith, Assyrian Discoveries, p. 432.
[400] As soon as these ivories arrived at the British Museum,
the learned keeper of the Oriental Antiquities was struck by their
Egyptian character. A paper which he published at the time may
be consulted with profit (Birch, Observations on two Egyptian
cartouches, and some other ivory ornaments found at Nimroud, in
the Transactions of the Royal Society of Literature, second series,
vol. iii. pp. 151–177.)
[402] Layard, Monuments, first series, plate 24.
[403] Ibid. plates 55 and 56. In the second stage of reliefs,
counting from the bottom.
[404] Among the ivories in case C of the Nimroud Gallery
there is a kind of blackish ivory egg, which may have served as
the knob of a sceptre. In an oval crowned by the uræus between
two feathers, we find an inscription which appears to be
Phœnician. It has been read as the name of a king of Cyprus.
Loftus, in a letter addressed to the Athenæum (1855, p. 351),
speaks of other ivories from the south-western palace at Nimroud.
They are the remains of a throne, and were found in a deposit of
wood ashes. He says there was a shaft formed by figures placed
back to back and surmounted by a capital shaped like a flower.
There was also, according to the same authority, a Phœnician
inscription.
[405] See Vol. I., pp. 299–302.
[406] My researches were not confined to the ivories in the
cases. I also went through the thousands of pieces in the closed
drawers which are not shown, in some instances because of their
broken condition, in others because they are merely duplicates of
better specimens in the selection exhibited.
[407] The feet found by Sir H. Layard at Nimroud must, as he
conjectured, have belonged to one of these tripods (Discoveries,
pp. 178–179).
[408] We should also mention another vase, shaped like the
muzzle of a lion, which was used to take liquids out of a large
crater set upon a stand (Botta, Monument de Ninive, vol. i. plate
76. See also M. Botta’s plate 162, where the chief examples from
the bas-reliefs are figured).
[410] In the eighth chapter of the Discoveries, Layard gives a
sort of inventory, rather desultory in form, perhaps, but
nevertheless very instructive and valuable, of the principal objects
found in the magazines—we have borrowed largely from these
pages. The most important of the cups are reproduced, in whole
or in part, in the plates numbered from 57 to 68 of the
Monuments, second series. A complete and accurate study of the
cups and other objects of the same kind discovered in Western
Asia will be found in M. Albert Dumont’s Les Céramiques de la
Grèce propre (pp. 112–129).
[411] Layard, Monuments, second series, plate 68.
[412] This platter is figured in Layard’s Monuments, plate 63,
but our drawing was made from the original.
[413] Art in Ancient Egypt, vol. ii. pp. 87–89.
[414] It is numbered 619 in the museum inventory. It bears an
inscription in Aramaic characters.
[415] Art in Ancient Egypt, vol. ii. figs. 280, 281.
[416] Inscriptions of this kind have been found on five or six of
the bronze platters in the British Museum. They are about to be
printed in the Corpus Inscriptionum Semiticarum, part ii.,
Inscriptiones Aramæa, vol. i.
[417] Thus, according to M. de Vogüé, who has examined the
inscriptions upon the cups recently cleaned, three of the cups
from Nimroud bear respectively the names of Baalazar (Baal
protects him), Elselah (El pardons him) and Beharel (El has
chosen him). Baalazar was a scribe.
[418] See above, p. 220, note 2.
[419] See Prisse, Histoire de l’Art egyptien, vol. ii. plate
entitled Le Pharaon Khouenaten servi par la reine. The kind of
saucer held by the queen is more like the Assyrian pateræ in
shape.
[420] See in Prisse’s Histoire, the plates classed under the
head Arts industriels, and especially the four entitled Vases en Or
émaillé et cloisonné. In all these I can only find one patera, in the
plate called Collection de Vases du Règne de Ramesés III. There
is nothing to show that the vases here figured were not
earthenware.
[421] Art in Ancient Egypt, vol. ii. figs. 287, 288. See also the
great vultures on the ceilings (ibid. fig. 282), and winged females
(ibid. fig. 287).
[422] Prisse, Histoire de l’Art egyptien, vol. ii., the plate
entitled Types de Sphinx.
[423] Art in Ancient Egypt, vol. ii. fig. 239, and Prisse, in the
plate above quoted.
[424] A cursory glance through the pages dedicated by Prisse
to the industrial arts is conclusive on this point, the heads of
snakes and horses, the figures of negroes and prisoners of war
are almost invariably placed back to back on the objects they are
used to adorn. Examples of this abound, but in order to
understand what we may call the principle of this ornamentation it
will suffice to refer to figs. 314, 327, and 328 of the second
volume of our History of Art in Ancient Egypt.
[425] In Prisse’s plate entitled Choix de Bijoux de diverses
Époques, there is a bracelet with a central motive recalling that of
our cup. It shows us two griffins separated by a palmette from
which rises a tall stem of papyrus between several pairs of
volutes. This object is, however, almost unique of its kind, and we
do not exactly know to what epoch it belongs. May it not belong to
a period when Egyptian art began to be affected by that of
Mesopotamia, an influence that is betrayed in more than one
particular? According to Herr Von Sybel, who has studied
Egyptian ornament with so much care, this motive of two animals
facing each other did not appear before the nineteenth dynasty,
and he looks upon it as purely Asiatic in its origin (Kritik des
Ægyptischen Ornaments, pp. 37, 38). We may also quote a small
box of Egyptian faïence inscribed with the oval of Ahmes II, the
Amasis of Herodotus. It bears two griffins quite similar to those of
our group, separated by a cypress. But Dr. Birch, who was the
first to publish this monument, recognizes that, in spite of the
cartouch, its physiognomy is more Assyrian than Egyptian
(Transactions of the Royal Society of Literature, Series II. p. 177).
[426] See on this subject an ingenious and learned paper to
which we shall more than once have occasion to refer, namely, M.
Clermont-Ganneau’s Étude d’Archéologie orientale, l’Imagerie
phénicienne et la Mythologie iconologique chez les Grecs. First
part: La Coupe phénicienne de Palestina (1880, 8vo, 8 plates).
[428] Houghton, On the Mammalia of Assyrian Sculptures, p.
382.
[430] Layard, Monuments, second series, plate 62, B.
[431] Rawlinson, The Five Great Monarchies, vol. i. chapter
vii.; Layard, Nineveh, vol. ii. pp. 338–348.
[432] Rawlinson, The Five Great Monarchies, &c., vol. i. pp.
408–410.
[433] Botta, Monument de Ninive, plate 159. In this plate the
chief types of weapons figured in the reliefs at Khorsabad are
brought together.
[434] Boscawen, Notes on an Ancient Assyrian Bronze Sword
bearing a Cuneiform Inscription (in the Transactions of the Society
of Biblical Archæology, vol. iv. p. 347. with one plate).
[435] Botta, Monument de Ninive, plate 160.
[436] Sayce, The Cuneiform Inscriptions of Van, in the Journal
of the Royal Asiatic Society, vol. xiv. p. 653. Mr. Pinches tells me
that there is a similar text on the hollow border of the shield
reproduced in our Fig. 225. Nothing is now to be distinguished,
however, but characters that may be read, “Great king, king of
——”.
[437] See vol. i. page 394.
[438] We cannot too often thank the keepers of the Oriental
antiquities in the British Museum for the trouble they took in
enabling us to give a figure of this hitherto unpublished
monument. The fragments, which had not yet been pieced
together or exhibited in the galleries, were arranged expressly for
our draughtsman.
[439] Nos. 385–391 in De Longpérier’s catalogue. These
objects came from the collection of Clot-Bey, which was formed in
Egypt but contained many things of Syrian origin. De Longpérier
did not hesitate, on the evidence of their style, to class these
objects as Assyrian, and any one who examines the motives of
their decoration will be of his opinion. See his Œuvres, vol. i. p.
166.
[440] Art in Ancient Egypt, vol. ii. pp. 394–395, and figs. 257,
329–331.
[441] De Longpérier, Notice des Antiquités assyriennes du
Musée du Louvre, third edition, No. 212.
[442] Many more varieties of the same type will be found in
the plate on which Botta reproduced the principal jewels figured
in the Khorsabad reliefs (Monument de Ninive, plate 161). See
also Layard, Discoveries, p. 597.
[443] The Arab jewellers still make use of similar moulds
(Layard, Discoveries, p. 595).
[444] Layard, Discoveries, pp. 177–178.
[445] Layard, Discoveries, p. 597. The oldest mention of the
pearl fisheries of the Persian Gulf is to be found in those
fragments of Nearchus that have been preserved in the pages of
Arrian (Indica, xxxviii. 7); but it is probable that the search for
pearl oysters began in those waters many centuries before. The
Assyrians, as we have seen, made use both of pearl and mother-
of-pearl.
[446] J. Oppert, L’Ambre jaune chez les Assyriens (in the
Recueil des Travaux relatifs à la Philologie et à l’Archéologie
egyptiennes et assyriennes, vol. ii, pp. 34 et seq.) M. Oppert’s
rendering of the paraphrase which he believes to specify amber is
not accepted by all Assyriologists.
[447] In the inventory, compiled with so much care by de
Longpérier, of all the little objects in the Assyrian collection of the
Louvre, and especially of those necklaces found by Botta in the
sand under the great threshold at Khorsabad (from No. 295 to No.
380), there is not the slightest mention of amber. MM. Birch and
Pinches tell me that the oriental department of their museum
contains no trace of amber, with the exception of a few beads
brought from Egypt, to which they have no means of assigning a
date. They have never heard that any of the Mesopotamian
excavations have brought the smallest vestige of this substance
to light.
[448] Arrian, Expedition d’Alexandre, vi. 29.
[449] The reputation enjoyed by Chaldæan textiles all over
western Asia is shown by a curious text in the book of Joshua
(vii. 21). After the taking of Jericho, Achan, one of the Israelites,
disobeyed orders and secreted a part of the spoil, consisting of
two hundred shekels of silver, a wedge of gold, and “a goodly
Babylonish garment.”
[450] “Pictas vestes apud Homerum fuisse (accipio), unde
triumphales natæ. Acu acere id Phryges invenerunt, ideoque
Phrygioniæ appellatæ sunt. Aurum intexere in eadem Asia invenit
Attalus rex: unde nomen Attalicis. Colores diversos picturæ
intexere Babylon maxime celebravit et nomen imposuit.” Pliny,
Nat. Hist. viii. § 74. Acu pingere, and for short, pingere, here
meant to embroider. Picta or picturata vestis was a robe covered
with embroideries.
[451] See Pliny, l. c. Lucretius, iv. 1026. Plautus, Stichus,
Act ii, Scene ii, v. 54. Silius Italicus, xiv. 658. Martial, Epigr.
xiv. 150. I borrow these citations from the first chapter of M.
Eugène Müntz’s Histoire de la Tapisserie in the Bibliothèque de
l’Enseignement des Beaux-Arts.
[452] See Vol. I. pp. 305–307.
[453] Nahum iii. 16.
[454] Ezekiel xvii. 4. Isaiah also alludes to the commerce of
Babylon (xlvii. 15).
[455] See on this subject, François Lenormant’s La Monnaie
dans l’Antiquité, vol. i. Prolégomènes, cap. iii. and especially pp.
113–122.
Ménant, Essai sur les Pierres gravées, p. 128.
[457] “... the Chaldeans whose cry is in the ships,” Isaiah xliii.
14.
[458] Taylor, Notes on the Ruins of Mugeyer (Journal of the
Royal Asiatic Society, vol. xv. p. 264).
[459] Strabo speaks of a Chaldæan settlement on the
Arabian coast of the Persian Gulf; he calls it Gerrha (xvi. iii. 3). All
the products of Arabia, he says, were there brought together.
Thence they were transported to Chaldæa by sea, and carried up
the Euphrates as far as Thapsacus.
[460] The juxtaposition on the black obelisk of Shalmaneser II.
of the rhinoceros, the small-eared or Indian elephant, and the
Bactrian camel seems to point to this route. The monkeys in the
same reliefs appear to belong to an Indian species (Houghton,
Mammalia of the Assyrian Sculptures, pp. 319, 320).
[461] Art in Ancient Egypt, vol. ii. figs. 257, 330 and 331.
[462] Art in Ancient Egypt, vol. ii. pp. 176–179.
[463] Soury, Théories naturalistes du Monde et de la Vie
dans l’Antiquité, cap. i. and ii.
[464] Ibid. cap. iii.
[465] Fr. Lenormant, Manuel d’Histoire ancienne, vol. ii. page
176.
[466] Soury, Théories naturalistes, p. 65.
[467] A. de Candolle, Origine des Plantes cultivées, pp. 285,
et seq.
Transcriber’s Notes:
1. Obvious printers’, punctuation and spelling errors have been corrected

silently.
2. Some hyphenated and non-hyphenated versions of the same words have

been retained as in the original.
3. Where hyphenation is in doubt, it has been retained as in the original.

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Foodborne Disease Handbook Vol II: Viruses, Parasites, Pathogens, and Haccp Second Edition, Revised and Expanded Edition Hui

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Foodborne Disease Handbook Vol II: Viruses, Parasites, Pathogens, and Haccp Second Edition, Revised and Expanded Edition Hui

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Foodborne Disease Handbook vol II:

Viruses, Parasites, Pathogens, and

Biota Grow 2C gather 2C cook Loucas

Foodborne Disease Handbook. Volume 2: Viruses,

Foodborne Disease Handbook vol IV: Seafood and

Foodborne Bacterial Pathogens: Methods and Protocols

Encyclopedia of policy studies Second Edition, Revised

Foodborne Viruses and Prions and Their Significance for

Graphic Design The New Basics Second Edition Revised

Graphic Design The New Basics Second Edition Revised

Volume 1 Bacterial Pathogens Volume 3 Plant Toxicants

Volume 2 Viruses, Parasites, Volume 4 Seafood and

Volume 2: Viruses, Parasites, Pathogens, and HACCP

MARCEL DEKKER, INC.

Reissued 2018 by CRC Press

Copyright © 2001 by Taylor & Francis Group, LLC.

No claim to original U.S. Government works

A Library of Congress record exists under LC control number: 00060172

ISBN 13: 978-1-315-89300-6 (hbk)

Introduction to the Handbook in

1. The Role of Poison Centers in the United States 1

2. Hepatitis A and E Viruses 23

3. Norwalk Virus and the Small Round Viruses Causing Foodborne

5. Other Foodborne Viruses 127

6. Detection of Human Enteric Viruses in Foods 137

1. Medical Management of Foodborne Viral Gastroenteritis and Hepatitis 165

8. Epidemiology of Foodborne Viral Infections 183

9. Environmental Considerations in Preventing the Foodborne Spread of

10. Taeniasis and Cysticercosis 217

11. Meatborne Helminth Infections: Trichinellosis 229

12. Fish- and Invertebrate-Borne Helminths 249

13. Waterborne and Foodborne Protozoa 289

14. Medical Management 323

15. Immunodiagnosis of Infections with Cestodes 347

16. Immunodiagnosis: Nematodes 375

17. Diagnosis of Toxoplasmosis 389

18. Seafood Parasites: Prevention, Inspection, and HACCP 407

IV. HACCP and the Foodservice Industries

19. Foodservice Operations: HACCP Principles 425

20. Foodservice Operations: HACCP Control Programs 457

Sabah Bidawid Food Directorate, Health Canada, Ottawa, Ontario, Canada

Ramsey C. Cheung Department of Medicine (Gastroenterology), Stanford University

Theresa L. Cromeans Hepatitis Branch, Division of Viral and Rickettsial Diseases,

John H. Cross Preventive Medicine and Biometrics, Uniformed Services University of

Debra D. DeVlieger Division of Emergency and Investigational Operations, U.S. Food

J. P. Dubey BARC, Parasite Biology and Epidemiology Laboratory, LPSI, Agricultural

Ronald Payer Agricultural Research Service, U.S. Department of Agriculture, Belts-

H. Ray Gamble Parasite Biology and Epidemiology Laboratory, Agricultural Research

VOLUME 1: BACTERIAL PATHOGENS

1. The Role of U.S. Poison Centers in Bacterial Exposures

II. Bacterial Pathogens

2. Bacterial Biota (Flora) in Foods

4. Update: Food Poisoning and Other Diseases Induced by Bacillus cereus

10. Listeria monocytogenes

11. Bacteriology of Salmonella

12. Salmonellosis in Animals

13. Human Salmonellosis: General Medical Aspects

15. Staphylococcus aureus

16. Vibrio cholerae

17. Vibrio parahaemolyticus

18. Vibrio vulnificus

III. Disease Surveillance, Investigation, and Indicator Organisms

20. Surveillance of Foodborne Disease