Epidemiology of FOOD POISONING.pptx.........................

illness caused by bacteria or other toxins in food, typically with vomiting and diarrhoea

1. FOOD POISOINING PREPARED BY KRUPA MATHEW.M, ASSOCIATE PROFESSOR

2. Food poisoning is an acute gastroenteritis caused by ingestion of food or drink contaminated with either living bacteria or their toxins or inorganic chemical substances and poisons derived from plants and animals. The condition is characterized by: (a) History of ingestion of a common food (b) Attack of many persons at the same time, (c) Similarity of signs and symptoms in the majority of cases. FOOD POISONING

3. Food poisoning may be of two types: Non-Bacterial Bacterial Non-Bacterial (a) Caused by chemicals such as arsenic, in certain plant and sea foods (b) Also by contamination of food by chemicals in fertilizers, pesticides. Bacterial Caused by the ingestion of foods contaminated by living bacteria or their toxins. TYPES OF FOOD POISONING

4. Salmonella food poisoning Staphylococcal food poisoning Botulism Clostridium perfringens food poisoning Bacillus . cereus food poisoning BACTERIAL FOOD POISONING

5. SALMONELLA FOOD POISONING An extremely common form of food poisoning.

6. Agent : S. typhimurium , S. cholera- suis and S. enteritidis , Reservoir : animals are the main source of infection. Man gets the infection from farm animals and poultry - through contaminated meat, milk and milk products, custards, egg and egg products. Host : Primarily Animals, man gets through contamination of infected animals Environment :Salmonellae are widely distributed in the environment - in dust, water, manure, sewage, sludge, vegetables, insects, birds, fish, rodents and other mammals. They can survive in soil for months . They may even multiply in the warm environment. Man may be infected from these sources. SALMONELLA FOOD POISONING EPIDEMIOLOGICAL DETERMINANTS

7. By ingestion of contaminated food or drink & direct contact with infected domestic animals especially such as dogs, pigeons, rats, mice and insects. Once man is infected, he becomes a source (case or carrier) and the infection may spread to others by the faecal -oral route . Transmission is facilitated by food handling methods, local customs, cooking and food habits, food processing, storage and distribution methods, and prevailing sanitary conditions. Salmonella Food Poisoning Mode of Transmission

8. Clinically, It is manifested by one of three syndromes: Enteric fever Salmonella enterocolitis (Gastro enteritis ): 6 to 48 hours after ingestion of Salmonellae, there is nausea, headache, vomiting and diarrhea. Low grade fever is common. The episode usually resolves in 2 to 3 days, but the stools often remain loose for several weeks. Septaesemia with focal lesions : Focal infection may result in osteomyelitis, pyelonephritis, arthritis, meningitis, cholecystitis and endocarditis Incubation Period : 12 to 24 hours commonly Salmonella Food poisoning Clinical features

9. Preventive measures should begin at the farm level are : Disease control, e.g., immunization of farm animals against salmonellosis. The use of hygienic animal feed Ensuring a sanitary environment for the animals. The aim is to raise "salmonella-free" animals. Salmonella Food poisoning Preventive Measures

10. The other approaches include: Hygienic slaughtering and milking Pasteurization of milk and egg Proper disposal of liquid and solid wastes Cold storage facilities Health education and training Team work of health sector, agriculture, veterinary and other department are needed in preventive measures. Salmonella Food poisoning Preventive Measures

11. AGENT : Enterotoxins of certain strains of coagulase-positive Staphylococcus aureus . There are 5 different enterotoxins have been identified. These toxins are relatively heat stable and resist boiling for 30 minutes or more . SOURCE : Staphylococci are ubiquitous in nature, and are found on the skin and in the nose and throat of men and animals . INCUBATION PERIOD : 1-8 hours. The incubation period is short because of "preformed" toxin. Staphylococcal food poisoning

12. Food poisoining results from ingestion of t oxins produced by the organisms in food (Intra Dietetic Toxins), is heat resistant and remain in the food even after the organism dies, The toxins act directly on the intestine and CNS. The illness becomes manifest The sudden onset of vomiting, abdominal cramps and diarrhoea . In severe cases, blood and mucus may appear. Staphylococcal food poisoning Mechanism of Food Poisoning

13. Most serious but rare. It kills two-thirds of its victims AGENT : Exotoxin of Clostridium botulinum generally Type A, B or E. The organism is widely distributed in soil, dust and the intestinal tract of animals and enters food as spores. The foods most frequently responsible for botulism are home preserved foods such as home-canned vegetables, smoked or pickled fish, homemade cheese and similar low acid foods. In fact, botulism derives its name from the Latin word for sausage ( botulus ). Botulism

14. The toxin is preformed in food (" intradietetic ”) under suitable anaerobic conditions, It acts on the parasympathetic nervous system. The prominent symptoms are dysphagia, diplopia, ptosis, dysarthria, blurring of vision, muscle weakness and even quadriplegia. Fever & diarrhoea are uncommon. The condition is frequently fatal, death occurring 4-8 days later due to respiratory or cardiac failure. Botulism occurring in infants is called “Infant botulism". Botulism Mechanism Of Food Poisoning PTOSIS

15. INFANT BOTULISM

16. AGENT : Clostridium (Cl.) perfringens ( welchii ). SOURCE : The organism has been found in faeces of humans and animals, and in soil, water and air. The majority of outbreaks have been associated with the ingestion of meat, meat dishes and poultry. INCUBATION PERIOD : 6 to 24 hours, with a peak from 10 to 14 hours Cl. Perfringens Food Poisoning

17. The spores are able to survive cooking, and if the cooked meat and poultry are not cooled enough, they will germinate. The organisms multiply between 30 deg. and50 deg. C and produce a variety of toxins, e.g., alpha toxin, theta toxin, etc. Prevention consists either by cooking food just prior to its consumption or, if it has to be stored, by rapid and adequate cooling Cl. Perfringens Food Poisoning Mechanism of food poisoning

18. The most common symptoms are diarrhoea , abdominal cramps and little or no fever, occurring 8 to 24 hours after consumption of the food. Nausea and vomiting are rare. Illness is usually of short duration, usually 1 day or less. Recovery is rapid and no deaths have been reported Cl. Perfringens Food Poisoning Clinical Features

19. Bacillus cereus is an aerobic, spore-bearing, motile, gram positive rod. It is present in soil, and in raw, dried and processed foods. The spores can survive cooking and germinate and multiply rapidly when the food is held at favourable temperatures . Bacillus. Cereus Food Poisoning

20. Emetic form : Short incubation period (1-6 hours) characterized by predominantly upper gastro-intestinal tract symptoms. Diarrhoeal form : Longer incubation period (12-24 hours) characterized by predominantly lower intestinal tract symptoms like diarrhoea , abdominal pain, nausea with little or no vomiting and no fever. Forms of Bacillus. Cereus Food Poisoning

21. Poisoning type Incubation period Mode of transmission Clinical feature Prevention & control Salmonella 12-24 hours By ingestion of contaminated food or drink Enteric fever Enteric colitis Focal leisons At farm level Environment Sanitation Staphylococcal 1-8 hours By preformed entero toxins Sudden vomiting, Abdominal cramp & diarrhoa As it is present in men personal hygiene needed Botulism Exotoxin of cl. Botulinum generally Type A, B or E. Acts on the CNS . dysphagia , diplopia , ptosis , dysarthria , blurring of vision As by home preserved foods, store in cool temperature Cl. Perfringens 6-24 hours, majority 10-14 hours Found in faeces of humans and animals, and in soil, water and air Diarrhoea Cramps & no fever Environment sanitation Bacillus. Cereus Emetic:1-6hrs Diarrheal: 12-24 hrs present in soil, and in raw, dried and processed foods. Emetic form Diarrhoeal form Environment sanitation

22. Common Clinical Features

23. It Should not be mistaken with Cholera All people who shared the foods to be monitored Laboratory Investigations like stool samples to determine the number of bacteria Blood for Antibodies Environmental studies Data Analysis are needed to investigate the type of food poisoning INVESTIGATION OF FOOD POISONING

24. FOOD SANITATION : Through Meat Inspection : By vetenary person Personal Hygiene : Food handlers should maintain their own personal Hygiene Food handlers : should be inspected for any infections Sanitary improvements : Sanitization of all work surfaces, utensils and equipments must be ensured. Food premises should be kept free from rats, mice, flies and dust. Health Education : Food handlers must be Educated on clean habits, personal hygiene & frequent Hand washing Prevention & Control of Food Poisoning

25. The handling of ready-to-eat foods with bare hands should be reduced to a minimum. Time between preparation and consumption of food should be kept short. The importance of rapid cooling and cold storage must be stressed Milk , milk products and egg products should be pasteurized. Food must be thoroughly cooked. Most food poisoning organisms are killed at temperatures over 60 deg. C. Food handling Techniques

26. B. REFRIGERATION: Emphasis must be on proper temperature control. Food should not be left in warm pantries; a few germs can multiply to millions by the next morning. Foods not eaten immediately should be kept in cold storage to prevent bacterial multiplication and toxin production . " Cook and eat the same day" is a golden rule. Prevention & Control of Food Poisoning