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Food-borne diseases Type of microbial foodpoisoning Standard case definition Salmonella Infectious (enterotoxin : multiply in GIT) Staphylococcal Intoxication

(exotoxin in the food/drink : enterotoxin ) Suspected case -Abrupt onset -Severe nausea+vomiting -Abd cramps -Prostration -May diarrhea -Duration : 24-48H Confirmed case -epidemiological data & isolation of S.aureus -Detect enterotoxin from suspected items/vomitus+stool Place worlwide Time summer Person All age Frequently in older ages Males 2-4 hours (sometimes 30 min) 1.Agent Staphylococcal aureus *toxin : heat stable 2.Reservoir botulism Intoxication (exotoxin : neurotoxin)

Suspected case -Unexplained diplopia -blurred vision -bulbar weakness accompanied by symmetrical paralysis Confirmed case -case with Lab confirmation -persons shared the same food

Descriptive epidemiolo gy

Incubation period Cycle of infection

Place Worldwide (myB sporadic/outbreak) In institutions (hospitals & nurseries) Time summer Person Any age & sex (especially very old and very young) 12-48 hours 1.Agent -Other than those causing typhoid & paratyphoid fevers -S.typhimurium

Place Most of countries (sporadic & small outbreaks) Time Depends on : - method of preparation of food products -local nutritional habits Person Person who consumes canned food 12-48 hours 1.Agent Clostridium botulinum (anaerobic bacillus) -types of antigenically distinct toxins for

-S.enteritidis *organisms are killed by : ~60c for 1 H ~chlorination of water ~cooking of food 2.Reservoir -animals : birds, cattle, rats,dogs, ducks, poultry and their eggs -man : patient/subclinical infection/ carrier (convalescent carrier) 3.Source of infection -food contaminated by excreta of infected animals/ man/ birds -raw eggs (especially duck egg & egg products) -meat products -poultry 4.Exit -GIT of infected man/ animal -milk from mastitis cow (S.typhimurium) 5.Mode of transmission -common vehicle : ingestion of contaminated food -mechanical : flies/ other insects 6.Inlet mouth 7.Susceptibility Severity related to : -serotype -dose of infection -host factors NO passive/active immunity

Man (carrier) Cow (rare) 3.Source of infection -contaminated food with the discharges from nose, throat, infected eyes, abscesses and infected fingers containing the staph toxin -milk and milk products -meat and meat products -contaminated ice cream 4.Exit -man (carrier) : infected fingers, eyes, abscesses, nose, throat, and skin -cows : infected udder 5.Mode of transmission Common vehicle : ingestion of contaminated food & drink 6.Inlet mouth 7.Susceptibility General but varies

human cases : A, B, E *toxin : heat labile 2.Reservoir -soil -water -intestinal tract of animals 3.Source of infection -canned food inadequately processed and eaten without cooking 4.Exit Dung of animals 5.Mode of transmission Common vehicles : Ingestion of inadequately process canned food 6.Inlet GIT 7.Susceptibility General

Period of communica bility Prevention

-Few days to several weeks -present of temporary carriers -ch carriers rare 1.measures for food (list the golden rules) 2.measures for animals : adequate animal husbandry 3.measures for food handlers : pre-employment, periodic xm & health education regarding personal hygiene. cases to local health authority 2.isolate patient from food preparation until stool culture is free 3.treatment : Antibiotics for septicemic patient/ presence of continuous fever 4.concurrent & terminal disinfections of faeces & contaminated articles contacts stool culture for food handlers

Non communicable Good hygiene among food handlers 1. protection of food from contamination education 3.pre-employment & periodic xm of food handlers 4.exclusion of persons suffering from skin, eye & throat infections from working in food preparation Cases to local health authority 2.treatment : -oral fluid (supportive therapy) -severe cases : IV fluids (rehydration) & electrolytes Contacts Investigation to find the source of infection especially in outbreaks

Non communicable 1.supervision of processing & preparation of canned & preserved food education of housewives (proper method of canning & preservation and value of boiling the canned food 3.discard bulging cans/those with peculiar odors Cases 2.treatment : -IV & IM injection of botulinum trivalent antitoxin (A,B and E) -intensive care to manage respi failure Contacts For those who ate form contaminated food : -kept under observation -giv enemas -giv purgative -antitoxin if indicated