Food-borne bacteria and bacterial toxins are a common cause of epidemic gastroenteritis. In general, the illness is relatively mild and self-limited, with recovery within 24 hours. However, severe and even fatal poisoning may occur with listeriosis, salmonellosis, or botulism and with certain strains of Escherichia coli. Poisoning after the consumption of fish and shellfish. Mushroom poisoning. Viruses such as the Norwalk virus and Norwalk-like caliciviruses, enteroviruses, and rotaviruses are the causative agent in as many as 80% of food-related illness. Other microbes that can cause food-borne illness include Cryptosporidium and Cyclospora, which can cause serious illness in immunocompromised patients. However, in over half of reported food-borne outbreaks, no microbiological pathogens are identified.
Gastroenteritis may be caused by invasive bacterial infection of the intestinal mucosa or by a toxin elaborated by bacteria. Bacterial toxins may be preformed in food that is improperly prepared and improperly stored before use or may be produced in the gut by the bacteria after they are ingested (Table II–28).
TABLE II–28.BACTERIAL FOOD POISONING |Favorite Table|Download (.pdf) TABLE II–28. BACTERIAL FOOD POISONING
|Organism ||Incubation Period ||Common Symptomsa and Mechanism ||Common Foods |
|Bacillus cereus || |
1–6 h (emetic)
8–16 h (diarrheal)
|V > D, S; toxins produced in food and gut ||Reheated fried rice, improperly refrigerated meats. |
|Campylobacter jejuni ||1–8 d ||D+, F; invasive and possibly toxin produced in gut ||Poultry, water, milk; direct contact (eg, food handlers). |
|Clostridium perfringens ||6–16 h ||D > V; toxin produced in food and gut ||Meats, gravy, dairy products. |
|Escherichia coli "enterotoxigenic" ||12–72 h ||D > V; toxin produced in gut ||"Traveler's diarrhea": water, various foods; direct contact (eg, food handlers). |
|E. coli "enteroinvasive" ||24–72 h ||D+; invasive infection ||Water, various foods; direct contact (eg, food handlers). |
|E. coli "enterohemorrhagic" (STEC, eg, 0157:H7) ||1–8 d ||D+, S; toxin produced in gut ||Water, ground beef, salami and other meats, unpasteurized milk and juice, contaminated lettuce and sprouts; direct contact (eg, food handlers). |
|Listeria monocytogenes ||Varies ||D+, S; invasive infection ||Milk, soft cheeses, raw meat. |
|Salmonella spp ||12–36 h ||D+, F; invasive infection ||Meat, dairy, eggs, water, sprouts; direct contact (eg, food handlers). |
|Shigella spp ||1–7 d ||D+, S; invasive infection ||Water, fruits, vegetables; direct contact (eg, food handlers, contact with contaminated reptiles/frogs). |
|Staphylococcus aureus ||1–6 h ||V > D; toxin preformed in food; heat-resistant ||Very common: meats, dairy, bakery foods; direct contact (eg, food handlers). |
|Vibrio parahemolyticus ||8–30 h ||V, D+; invasive and toxin produced in gut ||Shellfish, water. |
|Yersinia enterocolitica ||3–7 d ||D+; invasive infection ||Water, meats, dairy. |
The toxic dose depends on the type of bacteria or toxin and its concentration in the ingested food as well as individual susceptibility or resistance. Some of the preformed ...