Foodborne illness is a
significant public health concern all over the world. According to the World
Health Organization (WHO), 'The global incidence of foodborne disease is
difficult to estimate, but it has been reported that in 2005 alone 1.8 million
people died from diarrhoeal diseases.
A great proportion of these cases can be
attributed to contamination of food and drinking water.' In the United States
alone, around 48 million cases of foodborne diseases, resulting in 3,000
deaths, are estimated to occur each year.
Foodborne illness is a toxic or
infectious ailment that comes from eating contaminated food. The symptoms are
mainly flu-like that include nausea, vomiting, diarrhea, and/ or fever and the
onset of symptoms may occur within minutes to weeks. Pathogenic bacteria, virus
or parasites cause these illnesses.
Who is at risk? Everyone is at
risk for getting foodborne illness, but children below the age of 5, older
adults, pregnant women and people with weakened immune system such as those
with HIV, cancer, diabetes or those who got a transplant are at higher risk of
The CDC (Center for Disease
Control and Prevention), the FDA, along with other health departments have
tracked seven bacterial pathogens - Salmonella,
Escherichia coli (E. coli), Listeria, Campylobacter, Shigella, Yersinia,
- to be the causal organisms
of this illness. Although animals are the source of most of these pathogens,
researchers found that foodborne illness associated with fresh produce such as
lettuce, spinach, tomatoes, sprouts, cantaloupes and melons, is on the rise. In
fact, in 2011, one of the deadliest known listeriosis outbreaks in the U.S. was
associated with cantaloupes from a farm in Colorado.
The bacterial pathogens of
greatest concern are Salmonella
, E coli
(mainly O157:H7), and
), says Prof. Kimberly
Welch, Assistant Professor in Nesbitt College of Pharmacy and Nursing, Wilkes
University, Pennsylvania in her article on update on foodborne illness. The
article has been published in the U.S. Pharmacist journal.
Linked to animal products
including poultry and eggs as well as farm produce such as alfalfa sprouts,
tomatoes, jalapeρo peppers, black pepper, papayas, cantaloupes, and various
Salmonella is spread through
contaminated water and via fecal-oral route causing either non-typhoidal or
Symptoms include diarrhea,
nausea, vomiting, abdominal cramps, headache, and fever.
Occur within 72 hours of
exposure and last for 4 to 7 days.
Treatment may require
antibiotics viz. ceftriaxone or azithromycin in children and a fluoroquinolone
(commonly levofloxacin) or azithromycin in adults.
Other treatments include
rehydration therapy, salt intake through diet and digestible diet preferably
BRAT (banana, rice, applesauce and toast).
E. coli O157
Although E. coli is usually
harmless, E. coli O157 can cause bloody diarrhea in the host.
The pathogen is associated with
undercooked beef and beef products and fresh produce such as spinach, romaine
lettuce, hazelnuts, and clover sprouts.
Symptoms include severe
abdominal cramping, nausea, vomiting, and diarrhea that changes from watery to
Life threatening complications
include hemolytic uremic syndrome (HUS) which causes acute kidney failure and
thrombotic thrombocytopenia purpura (blood disorder that causes increased blood
clots and leads to a low platelet count).
Antibiotics and antimotility
drugs such as loperamide increase the risk of HUS, so treatment involves
rehydration and reducing risk of complications.
The pathogen causes listeriosis
and is associated with unpasteurized milk and milk products (e.g., soft
cheeses), meats, hot dogs, raw produce, and seafood.
The disease occurs within 3
days and may last from a few days to weeks.
Symptoms similar to diarrheal
ailments and includes fever, muscle aches, and nausea or diarrhea.
Listeriosis can cause severe
problems with pregnancy, including miscarriage or death in newborns.
Severe cases can cause
complications such as septicemia and meningitis.
Treatment includes rehydration
therapy and ampicillin (trimethoprim-sulfamethoxazole if allergic to
penicillin), for 3 to 6 weeks.
Preventive measures include -
Proper food storage,
refrigeration, handling, and cooking.
Avoiding unpasteurized milk and
milk products and raw or undercooked meat and poultry.
Eating more meals at home.
Washing raw fruits and
vegetables under running water.
Throwing away produce that has
been improperly stored or that may have been in contact with raw meat, poultry,
Cooking fish and fresh meats at
145 degree F and ground meat at 165 degree F.
Washing hands thoroughly before
and after eating.
Reducing cross-contamination by
using a separate cutting board and utensils for raw and fresh foods and frequently
disinfecting kitchen surfaces.
Prof Welch concludes - 'Pharmacists can help identify
individuals who may be at high risk for foodborne illness, educate patients
about how to prevent foodborne illness, make recommendations for self-care, and
report incidences of foodborne illness to the local health department and the