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Foodborne Infections
In The USA, 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 are food-related. Hospitalization costs alone for these illnesses are estimated at over $3 billion a year. Costs for lost productivity for 7 specific pathogens have been estimated to range between $6 billion and $9 billion. • • • • • • • • Several groups are more susceptibile to foodborne infections: People with lowered immunity due to HIV/AIDS, cancer treatment and organ transplantation Pregnant women (and their fetuses) Young children Elderly persons. Patients taking antibiotics, or antacids Persons living in institutional settings, such as hospitals and nursing homes Homeless persons, migrant farm workers, and others of low socioeconomic status.

Sources of Food Contamination Bacteria and other infectious organisms are pervasive in the environment. Salmonella enteritidis enters eggs directly from the hen. Bacteria (occasionally pathogenic) inhabit the surfaces of fruits and vegetables in the field. Molds and their toxic byproducts can develop in grains during unusually wet or dry growing seasons, damage and stress during harvesting, or during improper storage. Seafood may become contaminated from agricultural and other runoff, as well as by sewage, microorganisms, and toxins present in marine environments. Many organisms that cause foodborne illness in humans can be part of the normal flora of the gastrointestinal tract of food-producing animals. Milk, eggs, seafood, poultry, and meat may become contaminated due to contaminated feed, misuse of veterinary drugs, poor farming practices, poor production and harvesting activities and disposal of solid waste on land. Foods may become contaminated during processing due to malfunctioning or improperly sanitized equipment; misuse of cleaning materials; rodent and insect infestations and improper storage. Foods may become contaminated in retail facilities and in the home.

Common Foodborne Pathogens
• • Salmonella species, Campylobacter jejuni/coli,

• • •

Escherichia coli O157:H7 and other related strains Parasites Toxoplasma gondii and Cryptosporidium parvum; Norwalk virus.

Immediate consequences - an acute illness with abdominal pain, diarrhea and vomiting, Long-lasting conditions such as reactive arthritis, Guillain-Barr? yndrome (the most common cause of acute paralysis in adults and children), and hemolytic uremic syndrome (HUS), which can lead to kidney failure and death, particularly in young children. Salmonella Salmonella cause diarrhea and systemic infections, which can be fatal in susceptible persons, such as the immuno-compromised, the very young, and the elderly. An estimated 800,000 to 4 million infections occur each year in the US. In Canada 5500 cases were reported in 1997 , but this is likely a small percentage of infections that go undiagnosed and under-reported. Animals used for food production are common carriers of salmonellae, which may subsequently contaminate foods such as meat, dairy products and eggs. Foods often implicated in outbreaks: • • • • • • poultry and poultry products meat and meat products dairy products egg products seafood fresh produce.

Eggs are a common source of Salmonella enteritidis (SE) infections.. Over the past decade, more than 500 outbreaks have been attributed to SE with over 70 deaths. In 1994, an estimated 224,000 people became ill from consuming ice cream in one outbreak alone. There are two major salmonella species enterica and bongori. Most human pathogens belong to the S. enterica species, which has 6 subspecies and over 2000 serotypes; the S. thyphi and paratyphi serotyope are human pathogens only and may cause enteric fever and/or a chronic carrier state.Pets can besalmonella carriers. Treatment of uncomplicated gastroenteritis in otherwise healthy people with antibiotics is not advised but atnbiotic treatment is advised for those at increased risk of invasive disease. Multi-drug ressitant strains are common so that antibiotic treatment must be proceeded by culture of the bacteria and antibiotic testing. Campylobacter The bacterium, Campylobacter, is the most frequently identified cause of acute infectious diarrhea in developed countries and is the most commonly isolated bacterial intestinal pathogen in the United States. It has been estimated that

between 170,000 and 2.1 million cases of campylobacteriosis occur each year with an associated 120-360 deaths. Campylobacter jejuni and Campylobacter coli are foodborne and are the infectious agents most frequently associated with Guillain-Barr?yndrome, Several prospective studies have implicated raw or undercooked chicken as major sources of C. jejuni/coli infections. Unpasteurized milk and untreated water have also caused outbreaks of disease. Escherichia coli O157:H7 Several strains of the bacterium E. coli cause a variety of diseases in humans and animals.E. coli O157:H7 causes hemorrhagic colitis, which begins with watery diarrhea and severe abdominal pain and rapidly progresses to passage of bloody stools, and has been associated with HUS. HUS is a life-threatening complication of hemorrhagic colitis characterized by acute kidney failure, and is particularly serious in young children. E. coli O157:H7 has its reservoir in cattle, but the dynamics of E. coli O157:H7 in food-producing animals are not well understood. It has been estimated that approximately 25,000 cases of foodborne illness can be attributed to E. coli O157:H7 each year with an estimated 6 deaths. E. coli O157:H7 outbreaks have recently been associated with ground beef, raw milk, lettuce, and minimally processed and fresh fruit juices. The most recent outbreak, in the Fall of 1996 in 3 western states and British Columbia, was associated with unpasteurized apple juice. Toxoplasma gondii T. gondii is a parasitic protozoan. It has been estimated that 1.4 million cases of toxoplasmosis occur annually with an associated 310 deaths. Otherwise healthy adults who become infected usually have no symptoms, but may get diarrhea. Pregnant women who become infected during pregnancy may pass the disease to their fetuses. In infants infected before birth, fatal results are common. Should the infant survive, the effects of infection are typically severe. The disease can also be serious in persons with weakened immune systems and often is fatal to people with HIV/AIDS. T. gondii has been found in all food animals. Humans become infected by 1. consumption of raw or undercooked meat containing T. gondii or 2. contact with cats that shed cysts in their feces during acute infection and 3. ( less often) through the consumption of unwashed fruits and vegetables.. Cryptosporidium parvum C. parvum is a parasitic protozoan that causes watery diarrhea lasting up to several weeks. Children are particularly susceptible. Cryptosporidiosis can be lifethreatening in persons with compromised immune systems. The largest outbreak of cryptosporidiosis occured via infected drinking water in Milwaukee, Wisconsin in 1993; over 400,000 people became ill. Another waterborne outbreak in Las Vegas resulted in at least 20 deaths. The first large outbreak of cryptosporidiosis from a contaminated food occurred in 1993 and was attributed to fresh-pressed apple cider. Cryptosporidium is found in feces of infected mammals and has been transmitted through contaminated water and food. Norwalk virus Norwalk viruses cause sporadic and epidemic gastrointestinal disease with

dehydrating diarrhea. An estimated 181,000 cases occur annually in the USA with no known deaths. Outbreaks of Norwalk virus have been linked to contaminated water and ice, salads, frosting, shellfish and person-to-person contact; the most common food source is shellfish. Outbreaks have been caused by oysters contaminated by sewage dumped overboard by oyster harvesters and recreational boaters. Consumers make mistakes preparing food at home that increases the risk of foodborne illness. Studies show that 53% of the public eat food with raw eggs, 23% eat undercooked hamburger, 17% eat raw clams and oysters, and 26% do not wash their cutting boards after using them for raw meat or poultry. Foodborne illnesses have also been traced to commercial food establishments. Many food establishments do not know that the pooling and undercooking of eggs can increase the risk of Salmonella enteritidis. Institutional environments increase the risk of foodboren infection. In the US from 1988 to 1992, Salmonella caused 69% of the 796 bacterial foodborne disease outbreaks; 60% of these Salmonella outbreaks were caused by S. enteritidis. S. enteritidis also resulted in more deaths than any other pathogen with 85% of these deaths occurring among residents of nursing homes. Environmed Research Inc. ../alpha/index.htm../alpha/index.htm../nutriti on/index.htm../nutrition/index.htmNutrition Center
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<< Previous Next >> Food and Water Borne Infection Food and water are very important vehicles of infection. Good quality food and drinking water are amongst the most basic elements for ensuring good health including freedom from infection. Water A classic public health intervention in control of infectious disease (cholera) was the removal of the handle from a water pump in Broadstreet in London in the nineteenth century. The removal of the pump handle was based on recognition that the cholera cases were concentrated in those drawing water from that pump. This was before the bacterial cause of cholera was recognised. Water suitable for direct human consumption (potable water) is only generally available in developed countries. Surface (rivers, streams, reservoirs) and ground water (wells) is readily contaminated with faecal matter from humans, agricultural animals and birds. Faecal material may contain many pathogenic bacteria and viruses. Processing of water for human consumption requires filtration to remove organic debris and some types of potentially pathogenic organisms and chlorination to inactivate other potentially pathogenic microorganisms. The treated water is then distributed through an intact system of pipes, so that the water from the tap is suitable for direct consumption. If there is a failure in the water treatment process or an unrecognised break in the integrity of the distribution system very large numbers of people may be exposed to pathogenic micro-organisms in a short space of time. Large outbreaks of infection have occurred as result of such problems. In less developed countries lack of access to potable water is one of the major causes of ill health, in particular diarrhoeal disease.

Water is, more or less, an inert carrier of pathogenic microorganisms. It simply carries, in dilute form, the organisms that enter it. Typically water borne infections agents require only a small number of infectious particles to cause disease. Because the infectious dose is low the small numbers of microorganisms available in the diluted faecal matter is sufficient to cause infection. Where microbiologically safe water is not available boiling the water eliminates most infectious risks. Among the more important water borne infectious agents are the protozoan parasites Cryptosporidium parvum and Gardia lambia (cysts relatively resistant to chlorine), bacterial agents Salmonella typhi*, Vibrio cholera* and Enterotoxigenic E. coli* and viral agents Hepatitis A virus. (Those marked * are not endemic in W. Europe at present). Most often when we speak of water borne infection we are thinking about enteric infection but Legionella pneumophilia (an important cause of pneumonia) lives in water storage and distribution systems also. The organism survives chlorine at the usual levels used, partly because it can live within free-living amoebae where it is relatively protected from the effects of chlorination. Recreational Water Exposure to water also occurs during water sports. In the course of these activities there is contact of water with mucosa and some quantity of water may be swallowed, especially by small children. Water in swimming pools is treated with chlorine to inactivate pathogenic microorganisms shed by those using the pool. Apart form enteric pathogens there are other infections associated with swimming pools and baths. Pseudmononas aeruginosa is a Gram-negative bacillus that can accumulate to high numbers in recreational water that is not maintained at proper standards. The organism is sometime associated with infection of the hair follicles associated with contaminated pools or spas. Note Verruca (a type of wart of the foot) is also associated with recreational water use. The organism associated is Human Papilloma Virus. The virus is shed with skin squames on to floor area and is acquired by contact of bare feet with the floor. Microbiological Monitoring of Water Quality The principle microbiological measure of water quality is to culture the water for E. coli. Presence of E. coli in water implies recent faecal contamination and indicates that the water treatment or distribution system is not efficiently eradicating microorganisms from faeces. The E. coli strains detected may not be pathogenic but are evidence of that potentially pathogenic organisms of faecal origin could survive and be distributed in the water distribution system. Measuring chlorine concentration in water is also useful in ensuring that specified standards are maintained and low chlorine levels is one explanation for failure to clear E. coli from drinking water. Note Bottled Water and Travelling. If travelling in areas where potable water is not readily available from the tap many people purchase bottled water. In some countries the water in the bottles may be simply filled from a tap. It may be safer to buy carbonated bottled water because the presence of bubbles provides some reassurance that the seal is intact and the water has received some processing. Carbonated water has a low pH, which may reduce viability of some pathogens. Food Agents transmitted by water can also be transmitted by food as water is used in food preparation and in cleaning food preparation surfaces and utensils. There are additional problems with food. Food for humans is also food for bacteria, particularly if kept at a warm temperature. Many pathogenic bacteria can multiply to high numbers in food. Even pathogens for which a high infectious dose is required (Salmonella typhimurium for example) may be transmitted by food as the multiplication of the bacteria in food allows achievement of a sufficiently high concentration to cause infection. Bacteria growing in food may produce toxic substances. Illness after eating food may be related to intoxication rather than to true infection. Examples include S. aureus food poisoning, Clostridium perfringens food poisoning and botulism. Many modern foods and food storage systems are also good storage systems for pathogenic microorganisms and they may survive long periods of storage refrigerated or frozen. A number of traditional food storage systems like fermenting, pickling (low ph) or drying, storage in high concentrations of sugar are inhibitory or cidal for many species of bacteria.

Foods are now distributed over very wide areas of the world, whereas piped water supplies are more local. An outbreak of infection related to a widely distributed speciality food may cause a small number of infections in several different countries. Such an outbreak may be much harder to detect than an outbreak involving the same total number of people in a single city or county served by a water distribution system. Food (meat, milk, poultry and eggs) originating from animals may contain animal pathogens in the flesh (Toxoplasma gondii and Trichinella spiralis) and it easily becomes contaminated with microorganism from the intestinal tract of the animal (Salmonella enterica, Campylobacter spp., Enterohaemorrhagic E. coli) some of which may be pathogenic for humans. Intensive farming of large herds or flocks of food animals in confined indoor conditions probably facilitates rapid spread of potentially pathogenic bacteria to very large numbers of food animals. Can you tell by looking if food is contaminated? Food that is manifestly decomposed (smell/appearance) is clearly not fit for human consumption. Food "going off" is large measure to proliferation of bacteria most of which are not associated with human disease (spoilage organism). However pathogenic organisms may be present in significant numbers in food that in appearance, taste and odour is acceptable. Prevention of Food Borne Infection To put what follows in perspective it is important to note that at least in developed countries there is probably a greater abundance and variety of food, greater continuity of supply, lower cost and more convenience than at any time in history. The systems for mass production, storage and distribution that make this possible also create new possibilities for outbreaks of food borne infection of striking proportions. When food production and distribution were home or locality based, food related outbreaks of disease were a family or local problems and probably often unnoticed or unrecorded. Now if a single factory is preparing very large batches of a food product for distribution to thousands of consumers in 10 or more countries then a single failure may result in very dramatic infection in thousands of people. Well-publicised outbreaks generate considerable (and appropriate) public and professional emphasis on continually raising standards in relation to microbiological safety of food. Dining is the end step of a process that begins with the primary food source (animal, vegetable, fruit) and includes harvesting, processing, packaging, storage and preparation. Problems may occur at any of these stages. In educational material prepared by the Food Safety Authority of Ireland the concept safety from "farm to fork" is used (or sea to fork). A key element in modern approaches to ensuring food safety is HACCP, hazard analysis critical control point. HACCP means that the whole process of food production is examined to identify the hazards involved. For example a hazard of producing pre-cooked poultry meat is Campylobacter spp. commonly present in the intestinal tract of poultry and capable of causing quite severe diarrhoeal disease in humans. A critical control point is thorough cooking of the chicken so that the temperature in reaches about 72o for several minutes in all parts of the chicken. Such temperatures kill Campylobacter spp. so that the hazard is controlled at this critical control point. A facility for producing pre-cooked chickens can use temperature probes to ensure that the meat is heated adequately right through. This is safer and more efficient that cooking without precise temperature control and culturing a percentage of the product in the hope of detecting process failures. People who experience an episode of gastrointestinal infection due to food may well expect a health care professional to be able to advise on simple measures in the kitchen to reduce risk of future episodes or spread of infection. Some basic rules of food hygiene are as follows. Store uncooked meat (very often contains pathogens) on the bottom shelf of the refrigerator. (Campylobacter spp. Salmonella enterica, Enterohaemorrhagic E. coli). Avoid contact between uncooked foods (probably contaminated) and those foods that are ready to eat. Ready to eat foods included cooked foods and food that will be eaten without cooking (salad). Do not use the same surface or the same utensils used on uncooked food to prepare cooked food or foods that will be eaten without cooking (Campylobacter spp. Salmonella enterica, EH E. coli). Wash hands before preparing food (Salmonella enterica and Staphylococcus aureus, Clostridium perfringens). Cook meat and eggs thoroughly (heat kills most microbes). Do not store food at room temperature for long periods (Salmonella enterica, Staphylococcus aureus, Clostridium perfringens). Avoid unpasteurised milk or foods (cheese) made from unpasteurised milk (Campylobacter spp. Salmonella enterica, Mycobacterium bovis, Brucella spp, Listeria monocytogenes). This is especially important in pregnancy. Why? << Previous [Back To Top] Next >>

Salmonella
Salmonella is an infection caused by a gram-negative bacillus, a germ of the Salmonella genus. Infection with these bacteria may involve only the intestinal tract, or may spread from the intestines to the blood stream and then to other body sites. The source of infection is contaminated food or water, or close contact with other human beings carrying the infection.

SYMPTOMS AND DIAGNOSIS
Symptoms can vary greatly from person to person, may occur 12-72 hours after ingestion of contaminated food or water and may last 4-7 days. Most individuals experience two or more of the following symptoms: onset of severe headaches, abdominal cramps, diarrhea, nausea, vomiting, low grade fever and muscle aches. Some individuals experience no symptoms but harbor the bacteria in their intestines and are at risk of spreading it to other individuals. A diagnosis of Salmonella infection is made by testing a stool specimen for the presence of the bacteria.

TRANSMISSION
Salmonella live in the intestinal tracts of humans and other animals including birds, and are transmitted by the oral-fecal route. This means eating foods contaminated with animal feces. Contaminated foods usually look and smell normal. They are often of animal origin, such as beef, poultry, milk, or eggs, but all foods, including vegetables may become contaminated. Person-to-person transmission can also occur. Individuals who carry Salmonella in their intestines may transmit Salmonella to another individual if good personal hygiene is not followed. For example, an infected food handler may transmit the Salmonella bacteria if he/she does not wash his/her hands after using the bathroom and before handling or preparing food. Transmission may also occur by handling pet turtles, baby chicks, frogs and snails that harbor the Salmonella bacteria.

TREATMENT
Severe forms of Salmonella infection may require hospitalization and isolation from other people. Patients with less severe infection and those who are recovering may be treated at home. • • • • • Get plenty of rest until fever, diarrhea and any other symptoms have been gone for three days. Eat five or six small meals daily. Follow a progressive diet (clear liquids to full liquids to soft foods) as recommended by your provider. Use self-care measures such as comfortable room temperature and fresh air. You may wish to try a hot water bottle for stomach cramps. Symptomatic treatment with acetaminophen (Tylenol or similar product) for pain and fever is usually all that is required. Antibiotics generally are not recommended unless the infection has spread from the intestines, because such medication can prolong rather than reduce the period of bacterial shedding in the intestine. Individuals usually feel better within 5-7 days.

•

•

People who have Salmonellosis should not prepare food or pour water for others until they have been shown to no longer be carrying the Salmonella bacterium. Individuals working with food or in a health care facility, or day care center must have two negative stool cultures at least 72 hours apart before being allowed to return to work.

PREVENTION AND CONTROL
Good personal hygiene and handwashing techniques would prevent the majority of these transmissions. Wash hands thoroughly with warm, soapy water after visits to the restroom and before food preparation. Salmonella usually remains in the intestines for up to five weeks - and in some cases for many months. Be aware that some individuals can become chronic carriers of Salmonella bacteria and about 2% may develop chronic arthritis.
References: CDC Health Topics, General Information, 3-30-00

HEd. II-063 © The Board of Trustees of the University of Illinois, 2000. Rev. 09-29-00 Hed-hand Salmonella [ MHC Homepage || Health Information II Diseases/Conditions II Contagious/Communicable Diseases ]

E. coli O157 Can Kill Escherichia coli (E. coli) is the name given to a large family of bacteria commonly found in the gut of humans and animals. The majority of E. coli are harmless however, some types can cause illness. One particular type, known as E.coli 0157 may cause serious illness in humans ranging from diarrhoea to kidney failure and even death. Human infection has been increasing worldwide since the early 1980s. In 1996 Scotland had a large outbreak that affected over 500 people and 21 people died. Here in Ireland the number of reported cases has increased from 8, including 1 death, in 1996 to 76 cases in 1998. This increase in incidence is alarming and action is required to stop this upward trend. Low Infectious Dose Normally, it takes hundreds if not thousands of germs to make someone ill. Unfortunately, with E.coli 0157, the number required may be as little as 10 so even a small number of germs can cause serious illness, particularly in the young, the elderly and those already suffering from other diseases. Infection Reservoir E.coli 0157 is commonly found in the gut of healthy livestock and it is not currently feasible to eliminate it. It may also be present in unchlorinated water supplies or in contaminated ready-to-eat food. E.coli 0157 can be passed from person to person. This makes it so important to pay attention to food safety and hygiene at all stages of food production and preparation if foodborne illness is to be prevented. toptop Foods Implicated in Outbreaks Meat and Meat Products Minced meat Beef burgers Dry salami Roast beef

Fruit and Vegetables Bean sprouts Lettuce Apple juice (unpasteurised)

Dairy Products Unpasteurised milk Cheese Youghurt

Turkey roll Potatoes A wide range of foods from different sectors of the food industry are potential sources of E.coli 0157. The bacterium is a threat to consumers’ health and consequently to the food industry as a whole. Everyone in the food industry and consumers must be involved in the reduction of the risk of infection. Shared Responsibility Because of the seriousness of the disease, steps must be taken to reduce the risks of E.coli 0157 infection throughout the food chain: from farm to fork. Farmers, processors, distributors, retailers, caterers and consumers all have their part to play. All share the responsibility to minimise the risks. Control Measures for Food Factories Since it is not possible to eliminate E.coli 0157 from raw meat and vegetables at present it WILL find its way into the food factory. Processors should assume it is present and must employ a strategy whereby the bacterium is not allowed to multiply and where possible, employ a processing method to kill it. They should do this within a framework of a formal food safety management system.

Up to 30% of people infected with E.coli 0157 can develop kidney

failure and 3-5% of these people

die
By law, food businesses must have a food safety management system based on the principles of Hazard Analysis Critical Control Points (HACCP). Processors should use the Guide to Good Hygiene Practice (IS 342:1997) available from the NSAI to help them fulfil this obligation. Within this system, processors should pay particular attention to the following control measures designed to reduce the risk of E.coli 0157 infection: • Prevention of cross contamination between raw and ready-to-eat foods • Effective heat treatment of food • Careful management of food storage conditions. Up to 30% of people infected with E.coli 0157 can develop kidney failure and 3-5% of these people die. Prevention of Cross Contamination E.coli 0157 can be passed from raw food to cooked and ready-to-eat food. Because consumers may not heat these foods before consumption they may be at risk from infection. Cross contamination can be prevented by taking the following steps: • Physically separate raw and cooked or ready-to-eat foods at all times during processing, storage and distribution • Where this is not possible, the handling of raw and cooked or ready-to-eat foods should be separated in time and by a thorough and adequate cleaning protocol • Staff must wash their hands thoroughly between handling raw and cooked or ready-to-eat foods.

Adequate

cooking kills this germ

Effective Heat Treatment Cooking should ensure that the centre of the food is heated to at least a temperature of 70 ºC for 2 minutes or an equivalent time/temperature process. This will kill any E. coli O157 that may be present. Effective heat treatment involves both a time and a temperature element. Equivalent cooking processes could involve lower temperatures for longer times or higher temperatures for shorter times. Expert guidance should be sought when calculating equivalent cooking processes. Processing equipment that uses microwaves may not heat food evenly and processors must take care to avoid ‘cold spots’. Unlike food heated in conventional ovens, the centre may not necessarily be the coldest part for measurements used to confirm application of the correct cooking time and temperature. toptop Additional Measures Good Manufacturing Practice (GMP) regarding the safe storage and distribution of food will also minimise the risk of E.coli 0157 infection. The Guide to Good Hygiene Practice (IS 342:1997) contains details of GMP and these are recommended. Training of Food Handlers

An essential prerequisite of any food safety system is adequate staff training. Processors are required by law to ensure that staff who handle food are supervised and instructed and/or trained in food hygiene matters commensurate with their work activities. All staff working in a food business should be given a basic level of formal hygiene training. There should be a continual process of food safety education in the workplace. Exclusion from Work of Infected Staff Staff should stay at home if they have acute diarrhoea and in particular, if E. coli O157 infection has been diagnosed. If a case occurs in the workplace, management should seek advice from the local Health Board. 1. Contaminated product 2. Cross contamination 3. Inadequate refrigeration 4. Insufficient cooking 5. Poorly trained staff Specific Guidance for Meat Processors Minced meat and minced meat products are a major source of E.coli 0157. The bacterium, if present, will normally be on the external surfaces of whole joints but during mincing it is redistributed throughout the product. Similarly, rolled joints where the meat surface is turned inside means that any surface bacteria become distributed to the centre of the joint where they are more difficult to kill. The risk of E.coli 0157 multiplying in minced meat can be reduced by the following precautions: • Meat should be kept below 2 ºC. • Room temperatures in processing areas should be kept below 5 ºC. • Processors should adopt a food safety management system based on the principles of HACCP. • Mincing equipment should be regularly cleaned and sanitised. The E.C. (Mince Meat and Meat Preparations) Regulations, 1996 (S.I. No. 243 of 1996) require processors to withdraw batches of product in the event of a human health risk from a suspect meat source. To enable these obligations to be met processors should label discrete batches or lots of minced meat with a batch number. Correct identification may minimise the quantity of product recalled and will speed up the recall process thereby protecting consumers. To further protect and inform consumers, processors should label minced meat and minced meat products with clear cooking instructions: "Minced meat and minced meat products should be thoroughly cooked until the juices run clear and no pink meat remains". Human Infection People can become infected with E.coli 0157 by: 1. Coming into direct contact with livestock or livestock faeces 2. Drinking contaminated water or eating uncooked fruit and vegetables grown using contaminated water 3. Eating contaminated food 4. Coming into contact with the faeces of an infected person, most commonly small infants or frail people where personal hygiene practices may be inadequate. Spread of Infection Food handlers can spread the infection by: 1. Handling contaminated food and then other food that will not be further processed without washing hands 2. Using the same utensils for raw meat and other foods 3. Insufficient cooking 4. Using unchlorinated water in food production 5. Attending work while infected 6. Poor personal hygiene.

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Toxic waste imports put food in danger By Gerard Ryle May 8 2002

Related links: Industrial waste in fertilisers: Greens demand inquiry No looking back for the farmer happy to be a lab rat When 100% natural isn't 100% natural · Waste Lands - the in-depth investigation Toxic waste from China and other countries is being imported and used as a raw ingredient by some Australian fertiliser manufacturers and distributors. The wastes - from steelworks, electric-arc furnaces and zinc smelters - are being made into products that have shown heavy-metal levels up to 110,000 times higher than those which prompt NSW consumer warnings. They are being sold to unwitting farmers, mainly in Queensland and Western Australia, as zinc sulphate micronutrients to grow root vegetables destined for supermarkets.

The federal Department of the Environment confirmed yesterday it had intercepted two recent shipments of the material after being tipped off to the practice. The department tested the material and classed it as hazardous waste under Australian law. It was believed to be found to contain extremely high levels of cadmium, which can poison humans, vegetables and livestock. ''At the minute we are not prepared to talk about where it is being imported from ... We don't want to point the finger at any other country until we know more about it," a department spokesman said. ''It is an industrial residue and if you treat it correctly and subject it to chemical processes to clean it up, then you have clean zinc sulphate. The problem is shipments that haven't been cleaned up." The department said about 340 shipments of zinc sulphate were imported just from China last year. Thousands more tonnes are believed to be coming from other countries. The department said it was tipped off by a newspaper advertisement early last year warning farmers of the practice. It was placed by a Sydney company, Hardman Australia, which stopped making the product after it was undercut by cheap imports. ''What we are talking about is the dross from zinc smelters, the stuff that floats to the top," said its managing director, John Bradley. ''They take that dross because it is cheap and nobody wants it, it is a waste, and they refine that into zinc sulphate heptahydrate. ''In doing so they finish with very high levels of toxic waste metals within the product because it is not being made from clean material." He said importers were exploiting loopholes that do not require products to be re-tested for potential heavy-metal contaminants once they reach Australia. ''The trouble is that the Chinese are giving testing certificates on the products. But they are just lies, that's the nicest thing I can say. ''If we made that material we would be able to survive too, but we would poison everybody. It is madness. They are turning farms into waste dumps. ''And for some of this stuff, if you contaminate your ground with it, you might render it impossible to ever farm clean vegetables again." Mr Bradley said he discovered the practice after being forced to import the material: his company had found it uneconomic to keep producing a local product to strict Australian standards. Concerned about the Chinese certification that accompanied one shipment, he had it tested. The laboratory found it contained 11 per cent cadmium - or 110,000 parts per million. Mr Bradley said root crops grown in soil with cadmium levels as low as 0.3 parts per million could exceed World Health Organisation guidelines. He said the company had been priced out of the market ''because we are honest. We don't want to poison people. Everybody when they go down to the supermarket to buy their vegetables could be buying toxic, contaminated vegetables." Contact the reporter: [email protected] Printer friendly version Email to a friend

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Food Safety -- Keeping Food out of the Danger Zone

When preparing food for your family or to share with friends this holiday season, be sure to avoid the danger zone where bacteria grow rapidly -- temperatures between 40° and140° F. Use a food thermometer to check for safe temperatures. Pediatric dietitian Marilyn Tanner, MHS, RD, LD, offers this rule of thumb: “Keep the hot foods hot and the cold foods cold as much as possible.” Here are some additional tips for keeping your food safe this season: Keep your fridge cool. When a refrigerator is full, things can heat up. Buy a thermometer for your fridge and check it frequently to make sure the temperature stays below 40° F. Be careful with the bird. Thaw your turkey in the refrigerator and keep it there until you’re ready to cook it. Bring something easy. When going out of town for a gathering, offer to bring something non-perishable. Carry a cooler. Use your cooler to keep foods at a safer temperature while traveling. Watch that buffet. Put hot foods at one end of the table and cool foods at the other. And don’t let that cheese dip sit out for an afternoon of snacking -- foods can go bad in as little as two hours. Go online. You and your children (with the help of Thermy®) can learn more about food safety from the U.S. Food and Drug Administration at www.fsis.usda.gov. Safe Food Temperatures Whole turkey 180°F Poultry breast 170°F

Casseroles 165°F Fresh pork (medium) 165°F Fresh beef (medium) 160°F

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Contaminated Food Products Introduction As many as 5,000 Americans die each year from food-borne illness caused by contaminated food products. The CDC (Centers for Disease Control) reports that there are 76 million cases of food-borne illnesses every year and about 300,000 hospitalizations. The symptoms range from mild stomach distress to life-threatening conditions affecting the kidneys, liver and nervous system. Children under two are especially susceptible, as their immune systems are not fully developed. Public health data in 2000 show that there are more than five times the number of dangerous bacteria in our food than there were in 1942.The increase in food-borne illness appears to be linked to changes in our society.

Until recently, food was grown, processed and purchased close to home Now food may be grown one place, processed in another and sold in a third Raw materials that make up food often come from many different places

Foods may come from areas of the world that do not have the same sanitation standards that we do Eggs are the food group that caused the most outbreaks of food born illnesses Ground beef is the meat product most likely to cause an outbreak Recognition of the importance of routine fruit and vegetable consumption, together with the marked increase in the year-round availability of fresh produce from a global market has contributed to the substantial increase in consumption of fresh fruits and vegetables in the United States over the past two decades. Fruits and vegetables carry traces of materials from the areas in which they are grown. Whenever contaminated water or soil come in contact with fresh produce, there is a potential for pathogen contamination. Water and soil can be a carrier of many microorganisms including:

e.coli salmonella cholerae cryptosporidium giardia cyclospora hepatitis A virus These microorganisms can be carried on the skins of fruits and vegetables and can also contaminate other produce with which they come in contact. The availability of fresh fruits and vegetables from around the globe has resulted in a small number of outbreaks of food-borne illnesses due to e.coli and cyclospora in fruits and vegetables that are not subsequently processed to reduce or eliminate pathogens. To assist the U.S. and foreign produce industry in enhancing the safety of domestic and imported produce the Food and Drug Administration (FDA) has produced a guide for growers and importers to help minimize microbial contamination. This guide includes recommendations for testing water and soil for microbiological contaminants as well as testing produce handlers. If safe growing and handling practices are followed there is minimal risk of infection. The guide is available on the web at vm.cfsan.fda.gov/~dms/prodguid.html. Back to Top Food-borne Pathogens Food-borne pathogens are diseases that are found in food products. They can be bacterial or viral or come from a parasite. Many people don't link their illness to food-borne bacterium. They think they have a case of the flu. The severity of the symptoms caused by these pathogens can vary from a mild stomachache to death depending on the pathogen, the amount of exposure and the age of the child.

You can become sick any time from 20 minutes to six weeks after eating food with some types of harmful bacteria. For some people who are at high risk - young children, pregnant women, people over 65 and people with chronic illnesses - getting sick from food-borne bacteria can cause serious health problems. Knowledge of the safe handling of food can help reduce the risk of infection. Knowledge of the symptoms of foodborne illness can help a parent know when to take the child to the doctor for further diagnosis. Back to Top Bacterial Pathogens The following are all bacterial pathogens: Salmonella E.coli 0157:H7 Campylobacter Jejuni Listeria Monocytogenes Vibrio Vulnificus Salmonella Salmonella is one of the most common food-borne illnesses. The Center for Disease Control (CDC ) estimates there are from two to four million cases each year. Infants, the elderly, and those with immune deficit disorders are the most likely to suffer severe illness from salmonella. Food Sources Eggs Cake Mixes Peanut Butter Yeast Alfalfa Sprouts Cream filled Desserts and Toppings Unpasteurized Milk and Dairy Products Poultry Fish Cocoa Dried Gelatin Sauces and Salad Dressings Raw Meats Shrimp Chocolate Coconut Salmonella can be spread by improper hand washing or cross contamination (other food coming in contact with the salmonella bacterium on counter tops or elsewhere). Salmonella can also be spread by infecting the ovaries of a healthy-appearing hen who then contaminates the eggs before the shells are formed. Health Symptoms usually begin within 6 to 72 hours of ingesting salmonella and may last for one or two days or be prolonged depending on host factors, ingested dose and strain characteristics. Initial Symptoms include:

Minimal diarrhea Abdominal Pain Chills

Headache Fever Vomiting Dehydration Three to four weeks later arthritic symptoms may appear Warning: Infants and young children can become dehydrated from diarrhea, vomiting, and a high fever. If your child will not drink fluids or suck on Popsicle sticks contact your doctor as medical intervention may be needed. In infants, make sure that diapers are wet at regular intervals. Diagnosis If you think your child may be ill from salmonella contamination, take her to the doctor and ask to have culture isolated from the stool. Treatment Specific treatment is only indicated for complications caused by the ingestion of salmonella. Reducing the Risk Although eggs, meat, poultry, milk and other foods are safe when handled properly, the most common cause of salmonella poisoning is from eggs. The following tips will help reduce the risk of using eggs. Store eggs in the refrigerator until needed and cook them thoroughly before eating Discard cracked, dirty eggs Wash your hands and cooking utensils with soap and water after contact with raw eggs Refrigerate unused or leftover egg-containing foods Avoid eating raw eggs (as in homemade milkshakes, smoothies, ice cream or eggnog). Commercially manufactured ice cream and eggnog are made with pasteurized eggs and have not been linked with Salmonella infections Avoid restaurant dishes made with raw or undercooked shell eggs Follow the procedures listed in the Proper Handling and Storage of Food section of this website Back to Top E.coli 0157:H7

E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless and live in the intestines of healthy humans and animals, this strain produces a powerful toxin and can cause severe illness. The organism can be found on cattle farms and lives in the intestines of healthy cattle. Meat can become contaminated during slaughter, and organisms can be thoroughly mixed into beef when it is ground. Bacteria present on the cow's udders or on milking equipment may get into raw milk.

E.coli 0157:H7 must be swallowed to cause an infection. This can happen if you eat or drink something that contains these germs and is not thoroughly cooked or pasteurized The germs can be spread from person to person if someone who is infected does not thoroughly wash his or her hands with soap and water before preparing food for others. Spreading E.coli germs this way is more common in families and day-care centers than in schools and restaurants Eating meat, especially ground beef that has not been cooked sufficiently to kill E. coli O157:H7 can cause infection. Contaminated meat looks and smells normal. Although the number of organisms required to cause disease is not known, it is suspected to be very small. Cook foods to the proper temperature to kill E.coli. Using a food thermometer is the only sure way to know if your food has reached a high enough temperature to destroy food-born bacteria.

Source: www.fsis.usda.gov/oa/thermy/temprules.htm Also remember: Cook fish until it is opaque and flakes when tested with a fork Cook sauces, soups and gravy to 165F

E. coli )157:H7 can also be found in bacteria in the diarrheal stools of infected persons and can be passed from one person to another if hygiene or hand washing habits are inadequate. This is particularly likely among infants and toddlers who are not toilet trained. Family members and playmates of children infected with E.coli 0157:H7 are at high risk of becoming infected. Young children typically shed the organism in their feces for a week or two after their illness resolves. Older children rarely carry the organism without symptoms. Food Sources Ground Beef Roast Beef Alfalfa Sprouts Contaminated Drinking Water Vegetables Fertilized with Contaminated Cow Manure Raw Milk Apple Cider Salami Health Symptoms

Severe cramps Bloody stools Diarrhea Nausea Vomiting Fever In some persons, particularly children under five years of age and the elderly, the infection can also cause a complication called hemolytic uremic syndrome, in which the red blood cells are destroyed and the kidneys fail. About two percent to seven percent of infections lead to this complication. In the United States, hemolytic uremic syndrome is the principal cause of acute kidney failure in children, and most cases of hemolytic uremic syndrome are caused by E. coli O157:H7. Diagnosis Infection with E. coli O157:H7 is diagnosed by detecting the bacterium in the stool. Most laboratories that culture stool do not test for E. coli O157:H7, so it is important to request that the stool specimen be tested on sorbitolMacConkey (SMAC) agar for this organism. All persons who suddenly have diarrhea with blood should get their stool tested for E. coli O157:H7. Treatment Most persons recover without antibiotics or other specific treatment in five to 10 days. There is no evidence that antibiotics improve the course of disease, and it is thought that treatment with some antibiotics may precipitate kidney complications. Antidiarrheal agents, such as loperamide (Imodium), should also be avoided. Hemolytic uremic syndrome is a life-threatening condition usually treated in an intensive care unit. Blood transfusions and kidney dialysis are often required. With intensive care, the death rate for hemolytic uremic syndrome is three percent to five percent. Reducing the Risk The most important things to remember are that the bacteria can only make you sick if you swallow them, and that the germs are killed by thoroughly washing your hands with soap and water and by thorough cooking. Do not eat unpasteurized dairy products (such as cheese) Do not eat undercooked or rare ground beef Cook hamburgers until the center is 160F on a meat thermometer. Do not try to judge if meat is done by its color. Ground meat can turn brown before reaching 160F Cook fish until it is opaque and flakes when tested with a fork Cook sauces, soups and gravy to 165F

Do not drink raw milk Do not drink unpasteruized cider or apple juice Always use a food thermometer and cook meat until it reaches the proper temperature. (See: Temperature Rules) Do not put cooked meat - or anything else - on a cutting board or dish that has held raw meat Thoroughly wash fruits and vegetables - especially those eaten without cooking Drink municipal water that has been treated with disinfectants or use a water filter that eliminates e.coli 0157:H7 bacteria if drinking well water. See Safe Drinking Water: Selecting Bottled Water or a Home Water Filter System Teach your child to avoid swallowing lake or pool water when swimming Teach your child to always wash her hands with soap and water after going to the bathroom or changing a diaper Teach your child to always wash your hands before touching or eating food and after handling raw meat Anyone with diarrhea should avoid swimming pools, lakes, sharing baths with others or preparing food for others Note: Because E.coli 0157:H7 is a disease that can easily be spread to other people, health care providers are required by law to report cases of E.coli 0157:H7 to the local board of health. In order to protect the public, workers at food-related businesses who have E.coli 0157:H7 must stay out of work until they no longer have diarrhea and one lab test on a stool sample shows that there are no E.coli 0157:H7 germs. Workers in food-related businesses who have diarrhea and live with someone who has E.coli 0157:H7 must also show that they have none of the germs in their stool. Food-related businesses include restaurants, sandwich shops, hospital kitchens, supermarkets, dairy or food-processing plants. This regulation also includes workers in schools, residential programs, daycare, and health care facilities who feed, or dispense medications to clients. Back to Top Campylobacter Jejuni Campylobacter jejuni is the leading cause of diarrhea in the U.S. Children under five years old and young adults (15 - 29) are more frequently afflicted than other age groups. It usually occurs in isolated cases. The symptoms often are not severe enough to require medical intervention. Food Sources Poultry Contaminated water Raw meat Unpasteruized milk Health Symptoms usually begin two to five days after ingestion of the contaminated food or water and may last seven to 10 days though relapses are not uncommon. Most cases do not need treatment. Initial symptoms include:

Watery or Sticky Diarrhea Fever Abdominal Pain Nausea and Vomiting Headache Muscle Pain Warning: Infants and young children can become dehydrated from diarrhea, vomiting, and a high fever. If your child will not drink fluids or suck on Popsicle sticks contact your doctor as medical intervention may be needed. In infants, make sure that diapers are wet at regular intervals. Diagnosis Doctors can request a laboratory culture of a sample of stool from an ill person. This requires a special process that the doctor must specifically request. Treatment Most people recover without specific treatment within five to 10 days. Patients should drink plenty of fluids as long as the diarrhea lasts. In more severe cases, a physician may prescribe antibiotics. Reducing the Risk

Keep food safe at home Thaw foods in the refrigerator or a microwave Thoroughly wash hands with soap and water before and after handling raw meat or poultry Be sure countertops and utensils are clean Thoroughly cook all meat and poultry. (See: Temperature Rules) Do not drink unpasteurized milk or untreated water Microwave food in a covered dish or under plastic wrap (steam helps kill bacteria and ensures uniform heating). Rotate the dish or stir food during microwaving to ensure even cooking

Check the internal temperature of cooked food in several places with a temperature probe or food thermometer. The temperature should be at least 160F for meat and 180F in the inner thigh for poultry to destroy campylobacter and other bacteria Be sure to observe the "standing" time recommended in microwave recipes to complete cooking Do not reuse marinades from raw meat or poultry If you are served undercooked poultry in a restaurant, send it back for further cooking Freeze raw meat and poultry you will not use within one to two days Make sure anyone with diarrhea - especially children - wash their hands carefully and frequently with soap to reduce the risk of spreading infection Back to Top Listeria Monocytogenes Listeria monocytogenes (L. monocytogenes ) is found in soil and water and can contaminate a variety of raw foods such as uncooked meats and vegetables and soft or unpasteurized cheeses. Animals carry L. monocytogenes in their intestines without becoming sick. Human consumption of food contaminated with L. monocytogenes can cause listeriosis, an uncommon but potentially fatal disease in newborns, the elderly and persons with weakened immune systems. L. monocytogenes is a major concern for pregnant women as it can be transmitted to the fetus, causing serious illness or fetal death. L. monocytogenes is killed by cooking or by other heating methods such as pasteurization. However, ready-to-eat food can become contaminated after processing within the processing plant or along the route from plant to your plate. Food Sources Unpasteurized Soft Cheeses Meat Seafood Hot Dogs Unpasteruized Dairy Products Polutry Fruits or Vegetables Deli Salads Warning: Listeria monocytogenes can grow in foods under refrigeration, even at very low temperatures, which permits it to multiply in refrigerated foods. Health Symptoms may not be evident for up to 8 weeks after ingestion of the bacteria. If you are at risk and/or have symptoms that concern you, consult your physician. L. monocytogenes can be successfully treated with antibiotics. Symptoms may include:

Fever

Chills Upset stomach If the infection spreads to the nervous system:

Headache Stiff neck Confusion Loss of balance Convulsions Warning: While infected pregnant women may experience only mild, flu-like illness, the mother's illness can be transmitted to the fetus through the placenta. This can lead to miscarriage, stillbirth or serious health problems for her newborn child. Diagnosis Listeriosis can only be positively diagnosed by culturing the organism from blood, cerebrospinal fluid or stool. Treatment Complications such as listeric meningitis may occur and require treatment with antibiotics. Contact your doctor if you suspect your child has ingested food contaminated with listeria and request that a blood or cerebrospinal fluid sample be taken for diagnosis. Reducing the Risk

Cook all ready-to-eat foods such as hot dogs, luncheon meats, cold cuts, fermented and dry sausage and other delistyle meat and poultry products until they are steaming hot. Especially if you are pregnant, if you cannot cook these foods, do not eat them Do not drink raw, unpasturized milk or eat products made from it If you are pregnant, do not eat soft cheeses such as feta, Brie, Camembert or blue-veined varieties Wash hands, countertops and utensils with hot, soapy water Use hot, soapy water to clean up spills in the refrigerator

Keep ready-to-eat foods, raw meat, poultry and seafood separate from vegetables, fruits, breads and other foods already prepared for eating Cook foods to safe temperatures -160F for meat and 180F for poultry. (See Temperature Rules) Refrigerate or freeze perishable food within 2 hours Observe all expiration dates for perishable items that are precooked or ready-to-eat Wash kitchen sponges often by putting them in the dishwasher See Proper Handling and Storage of Food Back to Top Vibrio Vulnificus Vibrio vulnificus (v. vulnificus) is one of least common food-borne illnesses but it also one of the most serious to people with chronic liver disease or those with immune deficit disorders and may result in death for those individuals. Children with diabetes, leukemia or those who take immunosuppressive drugs or steroids are particularly vulnerable to "primary septicemia" which can result in septic shock. The bacterium may be found in the warm coastal waters around the United States and Mexico - particularly in the Gulf Coast states. The most common source of v. vulnificus is ingestion of raw oysters. However, the disease may also contaminate an open wound with seawater harboring the organism or may enter the body if one is pierced by a contaminated shell (as when shucking oysters). Food Sources Raw oysters Raw crabs Raw clams Raw mussels The mortality rate for individuals with liver disease or compromised immune systems who contact v. vulnificus is over 50%. Health Symptoms In healthy individuals, gastroenteritis (inflammation of the stomach or the intestine) usually occurs within 16 hours of ingesting the organism. Vomiting Diarrhea Abdominal pain Fever Chills

Decreased blood pressure (septic shock) Blistering skin lesions In vulnerable persons, ingestion of v. vulnificus can cause the "primary septicemia" form of gastroenteritis. Diagnosis Diagnosis is through culturing of the organism from wounds, stools or blood. Treatment V. vulnificus is treated with antibiotics. Reducing the Risk

Do not eat raw oysters or other raw shellfish Cook shellfish (oysters, clams, mussels, crabs) thoroughly For shellfish in the shell:

Boil until the shells open and continue boiling for 5 more minutes or Steam them until the shells open and then continue cooking for 9 more minutes Do not eat shellfish that do not open during cooking Boil shucked oysters at least 3 minutes Fry shucked oysters in oil at least 10 minutes at 375F Avoid cross-contamination of cooked seafood and other foods with raw seafood and juices from raw seafood Eat shellfish promptly after cooking Promptly refrigerate leftovers Avoid exposure of open wounds or broken skin to warm salt or brackish water or to raw shellfish harvested from such waters Wear protective clothing (e.g., gloves) when handling raw shellfish Back to Top

Viral Pathogens Hepatitis A

The Hepatitis A virus can be transmitted through food by someone with the disease who does not practice good hygiene or by contaminated water or ice either ingested or used to wash fruits and vegetables The virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of an infected person Unlike some other forms of hepatitis, hepatitis A causes no long-term damage and is usually not fatal Food Sources Contaminated Water Contaminated Ice Raw Shellfish Harvested from Sewage-Contaminated Water Fruits and Vegetables or Other Foods that May Have Heen Contaminated During Handling. Contaminated Salads and Sandwiches

Hepatitis A is also spread from person to person through improper hand washing after using the rest room or, in a daycare center, by changing infected diapers and not observing good hygiene with diaper disposal and hand washing. Health Symptoms Health symptoms may not be visible in children but are more likely in adults. Whey they occur, the usually develop suddenly and include:

Fever Tiredness Loss of Appetite Nausea Abdominal Pain Dark Urine Yellowing of the Skin and Eyeballs Diagnosis

A blood test (IgM anti-HAV) is needed to diagnose hepatitis A. You should talk to your doctor if you suspect that you or your child have been exposed to Hepatitis A or any type of viral hepatitis. Treatment There is no specific treatment for hepatitis A. However, immune globulin is used as temporary protection against this disease. Side effects due to immune globulin are rare and it can be used both before and within two weeks after exposure to hepatitis A virus. Reducing the risk

Practice good personal hygiene. Wash hands with soap and water After using the bathroom Before handling food

before eating When traveling to areas where hepatitis A is common, avoid Drinking water that may not be clean Eating uncooked vegetables and fruits

If you think you or your child have been exposed to hepatitis A, ask your physician or local health department if immune globulin is right for you. Be sure you and your child take immune globulin just before traveling to areas where hepatitis A is common. Note: Immune globulin is in extremely short supply and may be hard to get. Ask your doctor if you or your child over two should receive the hepatitis A vaccine. (The vaccine is not licensed in the United States for children under two.) Back to Top Protozoa Back to Top Reporting Illnesses If you have a serious food-borne disease your doctor may have already contacted the local health department Diseases typically reported include infections with Salmonella, E. coli O157, and other food-borne diseases, as well as tuberculosis, and many other communicable diseases This is done to detect outbreaks, and to protect public health If you have a notifiable disease the county health department may call you to make sure that you are improving and to learn more about how you might have caught it, as well as to advise you about how to keep it from spreading any further

Please cooperate with the public health nurse or investigator if they call you If you think you or others became ill from eating the same food, report it to your local health (city or county) health department. You can find your health department by clicking on http://www.cdc.gov/other.htm and scrolling down the page to "State and Local Health Departments." By investigating outbreaks, public health officials learn about problems in food production that lead to illness Applying what is learned in the investigation of one outbreak can help to prevent many future illnesses Back to Top Product Complaints Various kinds of food are handled and inspected by different parts of the government. There is no one place to contact if you have a question or a complaint or wish more information.

The Food Safety and Inspection Service of the FDA handles complaints about meat, poultry and egg products The Center for Food Safety and Applied Nutrition of FDA handles product complaints about seafood, Fruits, Vegetables and Other Non-Meat Food Products Complaints about food eaten away from home should be directed to your local health department Complaints about bottled water are handled by the Center for Food Safety and Applied Nutrition at the FDA Concerns about drinking water should be addressed to the Environmental Protection Agency If you have a question or complaint about food or water it is important to get in touch with the right governmental agency. By investigating questions and complaints, public health officials learn about problems in food production that lead to illness. Applying what is learned in the investigation of one complaint can lead to safer production and regulation of food and help prevent many future illnesses. Back to Top For More Information Back to Top

Contaminated Food Products Contents Introduction Food-borne Pathogens Bacterial Pathogens Viral Pathogens

Protozoa Reporting Illnesses Product Complaints For More Information