Foodborne Illnesses

World Scenario:
 2.1 million people died from diarrheal diseases in 2000 in the world  76 million cases of foodborne diseases results in 325,000 hospitalizations and 5,000 deaths in the US in 1999

Cost of Foodborne Illness
U.S. - $6.9 billion/yr. South Korea - $16-$28 million/yr. Australia - $1.7 billion in 1999

Philippine Scenario:
 Food-borne illnesses - classified as diarrheal disease  Diarrheal disease - #1 cause of morbidity (1,134.80 morbidity per 100 000 population) 9th of the top 10 causes of mortality 79% of foodborne illnesses cases in 1996 occurred while in the workplace, parties, and weddings or outside the home

Highly Susceptible Populations

Young Old Pregnant Immuno-compromised

Signs and symptoms

Upset stomach

Fever

Diarrhea

Vomiting

Dehydration
(sometimes severe)

Possible more severe conditions

Meningitis Paralysis

Don’t count on these to test for food safety!

Sight

Smell

Taste

Even IF tasting would tell …
Why risk getting sick?
A “tiny taste” may not protect you … as few as 10 bacteria could cause some foodborne illnesses!

Why gamble with your health?
It takes about ½ hour to 6 weeks to become ill from unsafe foods. You may become sick later even if you feel OK after eating.

Why risk other people’s health?
Is the food safe for everyone at the table?
Some people have a greater risk for foodborne illnesses. A food you safely eat might make others sick.

Cost of Foodborne Illness in the Food Service Industry

Ten Least Wanted Foodborne Pathogens
• Campylobacter jejuni • Clostridium botulinum • E.coli O157:H7 • Listeria monocytogenes • Salmonella spp. • Staphylococcus aureus • Shigella sp. • Toxoplasma gondii • Vibrio vulnificus • Yersinia enterocolitica

Ten Least Wanted Foodborne Pathogens
Causative Agent Source of Illness Symptoms Prevention Methods Cook food thoroughly, avoid cross-contamination, avoid unpasteurized milk Campylobacter jejuni Raw poultry, meat, and unpasteurized milk Diarrhea, fever, abdominal pain, nausea, headache, muscle pain, & sometimes bloody stool

Clostridium botulinum

Soil & water

Double vision, Practice timeinability to swallow, temperature control speech difficulty, & for large bulky foods, progressive paralysis cool leftovers rapidly of respiratory system

Ten Least Wanted Foodborne Pathogens
Causative Agent Source of Illness Symptoms Prevention Methods E. coli O157:H7 Infected cattle Severe abdominal pain, bloody diarrhea, nausea, vomiting Cook ground beef thoroughly, avoid crosscontamination, practice good personal hygiene

Listeria monocytogenes

Animal intestines, Nausea, vomiting, Avoid raw milk, cook soil, milk, leafy headache, fever, foods to proper vegetables, backache, respiratorytemperatures, avoid poultry, meat, distress, meningitis cross-contamination, seafood, & clean and disinfect prepared, chilled, ready-to-eat foods

Ten Least Wanted Foodborne Pathogens
Causative Agent Source of Illness Symptoms Prevention Methods Salmonella spp. Poultry, eggs, meats, fish, milk, & products made with them Nausea, fever, Avoid crossheadache, abdominal contamination of foods, cramps, diarrhea, & ensure thorough sometimes vomiting cooking of foods, prompt & proper refrigeration, practice good personal hygiene Avoid contamination from hands, exclude food handlers with skin infections from preparation, ensure proper refrigeration, rapid cooling of prepared food

Staphylococcus aureus

Human skin, nose, Diarrhea, vomiting, throat, infected nausea, abdominal sores, & in cramps, & physical animals exhaustion

Ten Least Wanted Foodborne Pathogens
Causative Agent Source of Illness Symptoms Prevention Methods Shigella sp. Fecally Abdominal pain, Avoid crosscontaminated food cramps, diarrhea, contamination of foods, or water fever, vomiting, & avoid fecal blood, pus, or mucus contamination by food in stool handlers, practice good personal hygiene, use sanitary food & water sources, ensure control of flies, cool food rapidly Animal feces, mammals, birds Enlarged lymph nodes in head & neck, severe headache, severe muscle pain, rash Avoid raw or undercooked meat, thoroughly cook meats, practice good personal hygiene

Toxoplasma gondii

Ten Least Wanted Foodborne Pathogens
Causative Agent Source of Illness Symptoms Prevention Methods Vibrio vulnificus Oysters & other shellfish Diarrhea, abdominal Avoid raw or cramps, nausea, undercooked seafood, vomiting, headache, avoid crosschills, fever, contamination blistering skin lesions Fever, severe abdominal pain, possible diarrhea, headache, sore throat, vomiting Avoid crosscontamination, thoroughly cook foods, sanitize food contact surface, proper storage procedures, use sanitary water supplies

Yersinia enterocolitica

Domestic pigs, soil, water, wild animals, rodents

Factors Contributing to Outbreaks of Foodborne Illness in Foodservice Establishments

3.5 5 9

2.5

2.5

2

2

0.5 1

0.2

0.1 0.1 30

11 13 17

Improper Cooling Advance Preparation Infected Person Inadequate Reheating Improper Hot Storage Contaminated Ingredient Unsafe Source Use of Leftovers Cross-Contamination Inadequate Cooking Toxic Substances Intentional Additives Improper Thawing Contaminated Water Mistaken for Food Improper Dishwashing

Factors Contributing to Foodborne Illness in the Philippines (by rank, by % outbreak, 1988-1996) • Improper food storage temperature • Poor hygienic practices • Inadequate cooking • Use of dirty utensils and equipment • Eating of expired and sewagecontaminated food

Trends in Food-borne Disease Outbreaks (FBDO) in the Philippines (1995 – 2004)
• Meat-based dishes and products – more significant causes of FBDO • Spaghetti meat sauce – main causative food vehicle

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

Food disease outbreaks in the Philippines (n=60, 1995-2004) classified by incriminated food types
Food Type Meat-based dishes and processed meat products Fish and other seafood dishes Bakery and confectionery products Toxin-containing or un-edible materials Other dishes Beverages Percentage (%) 31.67

20.00 16.67 13.33 10.00 8.33

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

Outbreak Location for Philippine Foodborne Disease (N=60, 1995-2004) Percentage (%) occurrence Home Workplaces Schools Restaurant Unknown 43.33 20.00 15.00 11.67 10.00 morbidity 18.17 38.61 24.60 7.67 10.96 mortality 96.00 4.00 0.00 0.00 0.00

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

Ranking of causative agents of foodborne poisoning in the Philippines based on recorded morbidity cases (n=3313 out of 60 outbreaks, 1995-2004) Type of Food Poisoning Microbiological Salmonella spp. Staphylococcal enterotoxin V. parahemolyticus paralytic shellfish toxin V. cholerae Histamine Aeromonas spp. E. coli Psylocibin/ Psilocin
*Unclassified
Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

Percentage % 29.73 23.15 14.49* 10.14 4.35 4.35 3.74 2.20 2.11 1.42

Chemical/ toxin

Ranking of causative agents of foodborne poisoning in the Philippines based on recorded morbidity cases (n=3313 out of 60 outbreaks, 1995-2004) continued…

Type of Food Poisoning Cigua toxin Jatropha curcas toxin Nitrite Amatoxin Tetradotoxin

Percentage % 1.15 0.75 0.75 0.51 0.63 0.21 0.15 0.15 0.12 0.09 0.03

Microbiological

Chemical/ toxin

Chlorphyllum molybdites toxin Arsenic Methanol Dioscorine B. cereus toxin Kerosene

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

Ranking of causative agents of foodborne poisoning in the Philippines based on recorded mortality cases (n=25 cases out of 60 outbreaks, 1995-2004)

Causative Agent Paralytic shellfish toxin Tetradotoxin Methanol Dioscorine Arsenic Unclassified Nitrite

Percentage (%) 34.62 19.23 19.23 7.69 7.69 7.69 3.85

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

2005 Food-borne disease outbreaks
Outbreak area Mabini, Bohol Concepcion, Tarlac Manaoag, Pangasinan Danao, Cebu San Jose, Camarines Sur Isla Verde, Batangas Pasay City Carrier Cassava Spaghetti Spaghetti Lechon Bantoli Causal agent Morbidit Mortaliti ies es Carbamate Staphylococcus 76 89 85 27 15 27 0 0 0 0

Steak Adobong kangkong

-

7 7

0 0

Source: Azanza, MPVA. (2005). Foodborne Diseases in the Philippines, 1995-2004.

Formula of Foodborne Illness

http://www.colostate.edu/orgs/safefood/safetyworks/handbook.pdf

Generally, foodborne illnesses are due to…
• Time-temperature abuse • Poor personal hygiene • Cross-contamination

Time-Temperature Abuse
• Situation at which food has been allowed to remain for too long at temperatures favorable for growth of microorganisms • Failing to hold or store foods at required temperatures • Failing to cook or reheat food to temperatures that kill microorganisms • Failing to cool foods properly • Preparing food a day or more ahead

Cross-Contamination
• Occurs when microorganisms are transferred from one surface or food to another

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