Foodborne infections remain a major public health problem.
The Council for Agricultural Science and Technology estimated in its 1994
report, Foodborne Pathogens: Risks and Consequences, that as many as 9,000
deaths and 6.5 to 33 million illnesses in the United States each year were
food-related. Hospitalization costs alone for these illnesses were estimated at
over $3 billion a year. Costs for lost productivity for 7 specific pathogens
estimated at $9 billion.
Doering reported in 2009: "The head of Kellogg
Co, whose company lost nearly $70 million in products from a recent peanut
recall, will tell lawmakers on Thursday the US food safety system must be
overhauled with a focus on prevention… the country needs an authority within the
Department of Health and Human Services devoted solely to food safety. Kellogg
and hundreds of other companies have recalled 3,491 products from crackers to
ice cream that contain peanuts after ingredients supplied by Peanut Corp of
America were linked to a salmonella outbreak that began in September. Peanut
Corp has since declared bankruptcy. The government says nearly 700 people have
become ill after eating contaminated peanut products. President Barack Obama has
organized a panel to improve food safety laws. He blamed the recent outbreak
partly on outdated food safety laws and underfunding and understaffing at FDA. In a 2009 review of the US experience, Maki asked: “Once again, we must ask ourselves how foodborne disease can develop in
76 million residents of one of the world's most technically advanced countries
each year, causing 350,000 hospitalizations and 5000 deaths and adding $7
billion to our health care costs, despite intensive regulation of food
production and distribution?”
The transportation of food in a global economy increased
the spread of foodborne infections. The spread of avian flu viruses, for example
was first blamed on wild birds, but tracking the spread with Google world
mapping showed that the virus spread along transport routes, moving domestic
foul for sale to distant countries. The idea of localized “endemic infections”
is obsolete. Bacteria and other infectious organisms are pervasive in the
environment. Salmonella enteritidis, for example, enters eggs directly from the
hen. Bacteria inhabit the surfaces of fruits and vegetables in the field. Molds
and their toxic byproducts can develop in grains during wet growing seasons and
when damp conditions prevail during harvesting or storage.
Seafood may become contaminated from agricultural runoff, by sewage,
microorganisms and toxins present in marine environments. Many organisms are
part of the normal flora of the gastrointestinal tract of food-producing
animals. Milk, eggs, seafood, poultry, and meat from food-producing animals may
become contaminated due to contaminated feed, misuse of veterinary drugs, or
poor farming practices.
Common foodborne pathogens
Escherichia coli O157:H7 and other related strains
Parasites Toxoplasma gondii and Cryptosporidium parvum;
Immediate consequences of these infections include acute
illness with abdominal pain, diarrhea and vomiting. Salmonella, E. Coli and
campylobacter actively infect after an incubation period of 1-3 days with acute
diarrhea, abdominal pain, and fever as the chief symptoms. An infection may
alter the immune reactivity of the DIGESTIVE TRACT surface, leaving new food
allergy in its wake. Many patients report an acute "food poisoning" episode at
the onset of a long bout of digestive symptoms, often with delayed pattern food
allergy downstream months later (fatigue, aching, headache, difficulty
concentrating, memory loss.) Long-lasting conditions may follow foodborne
infection - examples are reactive arthritis, sacroileitis, Guillain-Barré
syndrome and hemolytic uremic syndrome (HUS or "Hamburger Disease") which can
lead to kidney failure and death, particularly in young children.
Salmonella is the number one cause of diarrhea and systemic infections, which
can be fatal in particularly susceptible persons, such as AIDS patients, the
very young, and the elderly. An estimated 800,000 to 4 million infections occur
each year in the US.. Maki stated:” Between April and August 2008, Salmonella
enteritis was diagnosed in 1407 persons in 43 states, the District of Columbia
and Canada; 282 patients were hospitalized, and 2 elderly patients died.
Initially, the CDC suggested that contamination of tomatoes grown in the
southwestern United States was the cause, tomato consumption plummeted, and the
industry lost an estimated $200 million. Several months later, the outbreak
strain was isolated from jalapeño and serrano peppers that had been grown on one
Mexican farm, and the CDC concluded that the outbreak derived from contamination
of peppers that were eaten raw with tomatoes. Consumers are naïve and blame the
food as the agent of disease rather than blame food handlers for careless
practices. Animals used for food production are common carriers of salmonella,
which may subsequently contaminate foods such as meat, dairy products, and eggs.
Foods often implicated in salmonella outbreaks are: ·poultry and poultry products ·meat and meat products ·dairy products · egg
products ·seafood ·Fresh produce. Typhoid fever is caused by Salmonella Typhi (S typhi)
with an estimated worldwide prevalence of 12—33 million cases per year.
Extra-intestinal complications can occur with S. typhi infection, including the
involvement of the central nervous system (3—35%), cardiovascular system (1—5%),
pulmonary system (1—86%), bone and joints (≤1%), hepatobiliary system (1—26%),
genitourinary system (<1%). Due to an increase in multidrug-resistant S typhi,
fluoroquinolones and third-generation cephalosporins have been increasingly used
for typhoid fever and its complications.
Clostridium difficile infections are the leading cause of health care-associated
infectious diarrhea, posing a significant risk for both medical and surgical
patients. Antibiotics can cause or contribute to diarrhea. A major cause of
broad spectrum antibiotic- associated diarrhea and colitis is Clostridium
difficile infection (CDI) A gram-positive anaerobic spore-forming bacillus, C.
difficile spores have been reported to be present in foods such as fresh
vegetables, meat, and shellfish. CDI has become epidemic and is associated not
only with an increase in incidence and severity, but also an increase in rates
of CDI-related morbidity and a four-fold increase in CDI-related mortality
between 1999 and 2014 This infection is acquired via transmission of C.
difficile spores from individuals with active CDI or those who are
asymptomatically colonized and shed spores, individuals who have had contact
with CDI patients and carry the spores on their hands, and from spore-
contaminated environmental exposure. C. difficile spores are resistant to
stomach acid. In the small intestine spores germinate into the vegetative form
of the organism and produce exotoxins A and B.
Disruption of the normal intestinal flora is caused by exposure to
antimicrobial agents prompting C. difficile growth. Hospital infections
are increasing with associated morbidity and mortality. While hospital acquired
infections are of great concern, increasing evidence points to community
acquired infection. In a study reported in 2014, researchers with Kaiser
Permanente in the USA found that the majority of hospitalized patients
positive for C. difficile outside the hospital or within the first 72
hours of hospitalization. Stone reported:" In the USA C. difficile caused
infections in half a million patients in a single year. Approximately 29,000
patients died within 30 days of the initial diagnosis. Older Americans are
especially vulnerable to this deadly diarrheal infection. Two out of every three
healthcare-associated C diff infections occur in patients aged 65 years or
older. More than 80% of the deaths associated with C diff infection occurred
among Americans aged 65 years or older. More than 100,000 C diff infections
develop among residents of US nursing homes each year, making C diff infections
among the most serious healthcare complications that affect the nursing home
population. Unnecessary antibiotic use and poor infection control practices may
increase the spread of C diff within a healthcare facility and from facility to
facility when infected patients transfer, such as from a hospital to a nursing
home. More than 100,000 C diff infections develop among residents of US nursing
homes each year, making C diff infections among the most serious healthcare
complications that affect the nursing home population."
Alpha Education Books explain nutrition and the role of food choices in
causing disease. The most important books are listed below. Click the book title
in the center column to read sample topics. The author is
Stephen J. Gislason MD
Order Alpha Education Books
Click the Add to Cart buttons to order printed books for mail delivery
from Alpha Online.
Click the Download buttons to order and download eBooks as PDF files.
Persona Digital Books are also available. We ship through the Post Office to
all destinations in Canada and the USA. US $ costs are lower and depend on the
daily dollar exchange rate. Alpha Nutrition ® is a registered trademark and a
division of Environmed Research Inc., Sechelt, British Columbia, Canada. In business
since 1984. Online since 1995.