Professional Documents
Culture Documents
Bacteria Associated
with Foodborne
Diseases
This IFT Scientific Status Summary discusses Salmonella, Shigella,
Campylobacter, Listeria, and Vibrio species, and Yersinia enterocolitica,
Staphylococcus aureus, Clostridium perfringens, Clostridium botulinum,
Bacillus cereus, and Enterobacter sakazakii.
Table 1— Foodborne Disease in the United States, Including Estimated Annual Prevalence. Adapted from IFT (2000).
Bacteria Principal symptomsa Potential food contaminationa No. of illnessesb No. of deathsb
Bacillus cereus Diarrheal—watery diarrhea, abdominal Meats, milk, vegetables, fish 27,360 0
cramps and pain
Emetic—nausea and vomiting Rice products, starchy foods n/a n/a
Campylobacter spp. Watery diarrhea, fever, abdominal Raw chicken, beef, pork, shellfish, raw milk 1,963,141 99
pain, nausea, headache, muscle pain
Clostridium botulinum Weariness, weakness, vertigo, double Improperly canned or fermented goods 58 4
vision, difficulty swallowing and speaking
Clostridium perfringens Intense abdominal cramps, diarrhea Meat, meat products, gravies 248,520 7
Enterobacter sakazakii c Meningitis, enteritis Powdered infant formula 1:100,000 infantsc 20-50%c
Listeria monocytogenes Nausea, vomiting, diarrhea; influenza-like Raw milk, cheeses (particularly soft ripened 2,493 499
symptoms, meningitis, encephalitis; varieties), raw vegetables, raw meats, raw
septicemia in pregnant women, their and smoked fish, fermented sausages
fetuses, or newborns; intrauterine or cervical
infection that may result in spontaneous
abortion or stillbirth
Salmonella Typhi and Typhoid-like fever, malaise, headache, Raw meats, poultry, eggs, milk and 659 3
Salmonella Paratyphi abdominal pain, body aches, diarrhea, dairy products, fish, shrimp, yeast, coconut,
or constipation sauces, salad dressings (i.e., homemade items
containing unpasteurized eggs and no or
insufficient acidification for destroying pathogens)
Other Salmonella spp. Nausea, vomiting, abdominal cramps, fever, Raw meats, poultry, eggs, milk and 1,341,873 553
headache; chronic symptoms (e.g., arthritis) dairy products, fish, shrimp, yeast, coconut,
sauces, salad dressings (i.e., homemade items
containing unpasteurized eggs and no or
insufficient acidification for destroying pathogens)
Shigella spp. Abdominal pain and cramps; diarrhea; Salads (potato, tuna, chicken, macaroni) 89,648 14
fever; vomiting; blood, pus, or mucus raw vegetables, bakery products (e.g.,
in stools, tenesmus cream-filled pastries), sandwich fillings,
milk and dairy products, poultry
Staphylococcus aureus Nausea, vomiting, retching, abdominal Meat and meat products, poultry, egg 185,060 2
cramps, prostration products, salads (chicken, potato, macaroni),
cream-filled bakery products, milk and
dairy products
Vibrio cholera Serogroup 01 Mild watery diarrhea, acute diarrhea, Raw or recontaminated oysters, clams, crabs 49 0
rice-water stools
V. cholera Serogroup non-01 Diarrhea, abdominal cramps, fever, vomiting, Raw or recontaminated oysters, clams, crabs 49 0
nausea; blood or mucus-containing stools
Vibrio vulnificus Fever, chills, nausea, septicemia in individuals Raw or recontaminated oysters, clams crabs 47 18
with some underlying diseases or taking
immunosuppressive drugs or steroids
Other Vibrio spp. Diarrhea, abdominal cramps, nausea, Raw, improperly cooked or recontaminated n/a n/a
vomiting, headache, fever, chills shellfish or fish
Yersinia enterocolitica Fever, abdominal pain, diarrhea and/or vomiting Meats, oysters, fish, raw milk 86,731 2
a
Based on FDA/CFSAN (2003b).
b
Based on Mead et al. (1999). n/a indicates that no estimate was provided for this pathogen.
c
From WHO (2004).
2 INSTITUTE OF FOOD TECHNOLOGISTS AUGUST 2004
taminated with fecal matter. Coastal wa- tices as major contributors to foodborne practices probably have the greatest
ters may also naturally harbor the illness (Altekruse et al., 1996; Meer and chances for success in controlling food-
pathogen Vibrio vulnificus. It is thus ob- Misner, 2000). For most of the patho- borne illness. The need for continual
vious how difficult it is to prevent one gens discussed in this Scientific Status education of consumers and all food
or more pathogens from contaminating Summary (Table 1), illness can be avoid- handlers concerning the significant haz-
foods. ed by heating and cooling foods to the ards associated with foodborne patho-
The presence of potentially life- appropriate temperatures, storing foods genic microorganisms and proper food
threatening pathogens in our environ- at the appropriate conditions for the handling procedures is evident. Regula-
ment, the ability of some of them to recommended period of time, hand- tory control over food handling in the
survive and/or proliferate under refrig- washing, and avoiding cross-contamina- home is not possible, but increased con-
eration and in reduced oxygen atmo- tion. Delicatessens, cafeterias, and res- sumer education could have a beneficial
spheres, and, for some pathogens, the taurants were responsible for 33% of effect.
low number necessary for causing dis- outbreaks (CDC, 2000b). Only one of
ease indicate the seriousness of the po- more than 1,300 outbreaks, including Salmonella
tential hazards with which we are faced. bacterial and viral, with known or un- Russell S. Flowers
The food industry implements a variety known etiology, was attributed to a
of effective control measures to limit “commercial product” in 2000 (CDC, Salmonella is a generic name applied
potential hazards. This generally begins 2000d). Proper handling, cooking, and to a group of nearly 2,000 biochemically
on the farm with the implementation of storage practices in foodservice opera- related serotypes responsible for food-
good agricultural practices. Some raw tions and in the home can prevent the borne illness.
products, such as poultry, are subject to majority of foodborne illnesses.
performance standards in spite of the In the foodservice sector, education Significance as a Pathogen
fact that the consumer will presumably of the food preparer and server, with The total number of cases of human
cook the product before consumption. emphasis on good personal hygiene, is salmonellosis have remained fairly con-
While all food manufacturers utilize the best preventive measure. Unfortu- stant between 1996 and 2002 (Figure 1),
control measures to ensure food safety, nately, the majority of foodservice although the serotypes causing illness
some food manufacturers are required workers are young (under 30 years of have changed (CDC, 2003a). Roughly
to create and follow a Hazard Analysis age), inexperienced, and stay on the job two to four million cases of foodborne
and Critical Control Point (HACCP) less than a year; thus, finding and edu- salmonellosis occur annually in the
plan. Critical control points identified cating these food handlers while they United States, and the estimated 1.3
through HACCP may include destruc- are actively working is difficult (Marth, million cases that occurred in 2000 cost
tion or inactivation of the relevant bac- 1985; National Restaurant Association, $2.4 billion in medical costs and lost
teria or their spores through the use of 2004). productivity (USDA/ERS, 2003). Be-
heat treatments (e.g., pasteurization, However, training programs such as tween 1988 and 1995 there were be-
canning), dehydration, freezing, refrig- Servsafe®, conducted through the Na- tween 40,000 and 50,000 reported, con-
eration, specialized packaging, and/or tional Restaurant Association Education firmed cases of salmonellosis annually;
approved antimicrobial preservatives. Foundation, and SuperSafeMark®, of- since 1997, that number has been below
Additionally, extensive quality control fered through the Food Marketing Insti- 35,000 (CDC, 2004; FDA/CFSAN,
procedures are maintained to ensure tute, have a positive impact on retail 2003b).
that these processes are effective. food safety practices (Cotterchio et al., The disease is grossly underreported
It is impossible, however, to create a 1998; Lynch et al., 2003; Mathias et al., because it is generally a self-limiting
risk-free food supply. While food manu- 1995). gastroenteritis which may be misdiag-
facturers and distributors employ neces- Several studies and reviews have nosed as intestinal influenza by the pa-
sary control measures to ensure the highlighted the contribution of chang- tient or the physician. As a consequence,
safety of food until it reaches the con- ing demographics in the United States estimates of the true incidence of dis-
sumer, all food handlers and consumers with the increased risk of foodborne ill- ease are based on assumptions derived
have the responsibility upon purchase ness (Knabel, 1995; Zink, 1997). The in- from epidemiological evidence. Clearly,
of the food to maintain these control crease in the elderly population and in- salmonellosis continues to be an impor-
measures until consumption. While dividuals with weakened immune sys- tant cause of foodborne disease world-
outbreaks associated with a particular tems underscores the need for rigorous wide.
commercially processed food receive food safety efforts, both on the part of Two clinical manifestations caused
widespread public attention, a much the food manufacturer and the consum- by Salmonella are recognized: enteric fe-
greater number of individual cases of er. Foodborne illnesses are more likely ver (a severe, life-threatening illness)
foodborne illness occurring in restau- to be life-threatening for the immune and the more common foodborne ill-
rants and in the home are not reported. compromised, the elderly, and individu- ness syndrome. In both cases, the re-
The Centers for Disease Control and als debilitated by underlying health sponsible microorganisms enter the
Prevention (CDC) reported that be- problems such as cirrhosis, hepatitis, body via the oral route.
tween 1993 and 1997, approximately hemachromatosis, etc. Enteric fever, commonly referred to
19% of foodborne illness outbreaks oc- Consumer education and increased as typhoid fever, is primarily caused by
curred in private residences. Numerous regulatory control of foodservice estab- one species, Salmonella Typhi, but other
surveys have highlighted inadequate lishments through inspection and strict salmonellae such as Salmonella
home food storage and handling prac- enforcement of proper food handling Paratyphi are potentially capable of pro-