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Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 1 of 314 FDA Home Page | CFSAN Home | Search/Subject Index | Q & A | Help Foodborne Pathogenic Microorganisms and Natural Toxins Handbook The "Bad Bug Book" This handbook provides basic facts regarding foodborne pathogenic microorganisms and natural toxins. It brings together in one place information from the Food & Drug Administration, the Centers for Disease Control & Prevention, the USDA Food Safety Inspection Service, and the National Institutes of Health. Some technical terms have been linked to the National Library of Medicine's Entrez glossary. Recent articles from Morbidity and Mortality Weekly Reports have been added to selected chapters to update the handbook with information on later outbreaks or incidents of foodborne disease. At the end of selected chapters on pathogenic microorganisms, hypertext links are included to relevant Entrez abstracts and GenBank genetic loci. A more complete description of the handbook may be found in the Preface. PATHOGENIC BACTERIA Salmonella spp. Clostridium botulinum Staphylococcus aureus Campylobacter jejuni Yersinia enterocolitica and Yersinia pseudotuberculosis Listeria monocytogenes Vibrio cholerae O1 Vibrio cholerae non-O1 Vibrio parahaemolyticus and other vibrios Vibrio vulnificus http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 2 of 314 Clostridium perfringens Bacillus cereus Aeromonas hydrophila and other spp. Plesiomonas shigelloides Shigella spp. Miscellaneous enterics Streptococcus ENTEROVIRULENT ESCHERICHIA COLI GROUP (EEC Group) Escherichia coli - enterotoxigenic (ETEC) Escherichia coli - enteropathogenic (EPEC) Escherichia coli O157:H7 enterohemorrhagic (EHEC) Escherichia coli - enteroinvasive (EIEC) PARASITIC PROTOZOA and WORMS Giardia lamblia Entamoeba histolytica Cryptosporidium parvum Cyclospora cayetanensis Anisakis sp. and related worms Diphyllobothrium spp. Nanophyetus spp. Eustrongylides sp. Acanthamoeba and other free-living amoebae Ascaris lumbricoides and Trichuris trichiura VIRUSES Hepatitis A virus Hepatitis E virus Rotavirus Norwalk virus group http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 3 of 314 Other viral agents NATURAL TOXINS Ciguatera poisoning Shellfish toxins (PSP, DSP, NSP, ASP) Scombroid poisoning Tetrodotoxin (Pufferfish) Mushroom toxins Aflatoxins Pyrrolizidine alkaloids Phytohaemagglutinin (Red kidney bean poisoning) Grayanotoxin (Honey intoxication) OTHER PATHOGENIC AGENTS Prions APPENDICES Infective dose Epidemiology summary table Factors affecting microbial growth in foods Foodborne Disease Outbreaks, United States 1988-1992 Additional Foodborne Disease Outbreak Articles and Databases. Foodborne Illness CFSAN Home | CFSAN Search/Subject Index | CFSAN Disclaimers & Privacy Policy | CFSAN Accessibility/Help FDA Home Page | Search FDA Site | FDA A-Z Index | Contact FDA FDA/Center for Food Safety & Applied Nutrition Hypertext updated by mow/las/dav/ear April 25, 2006 http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 4 of 314 http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 5 of 314 FDA Home Page | CFSAN Home | Search/Subject Index | Q & A | Help Foodborne Pathogenic Microorganisms and Natural Toxins Handbook Salmonella spp. 1. Name of the Salmonella is a rod-shaped, motile bacterium -- nonmotile exceptions S. gallinarum and S. pullorum--, Organism: nonsporeforming and Gram-negative. There is a widespread occurrence in animals, especially in poultry and Salmonella spp. swine. Environmental sources of the organism include water, soil, insects, factory surfaces, kitchen surfaces, animal feces, raw meats, raw poultry, and raw seafoods, to name only a few. 2. Nature of Acute S. typhi and the paratyphoid bacteria are normally caused septicemic and produce typhoid or typhoid-like fever Disease: in humans. Other forms of salmonellosis generally produce milder symptoms. 3. Nature of Disease: Acute symptoms -- Nausea, vomiting, abdominal cramps, minal diarrhea, fever, and headache. Chronic consequences -- arthritic symptoms may follow 3-4 weeks after onset of acute symptoms. Onset time -- 6-48 hours. Infective dose -- As few as 15-20 cells; depends upon age and health of host, and strain differences among the members of the genus. Duration of symptoms -- Acute symptoms may last for 1 to 2 days or may be prolonged, again depending on host factors, ingested dose, and strain characteristics. Cause of disease -- Penetration and passage of Salmonella organisms from gut lumen into epithelium of small http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 6 of 314 intestine where inflammation occurs; there is evidence that an enterotoxin may be produced, perhaps within the enterocyte. 4. Diagnosis of Human Serological identification of culture isolated from stool. Illness: 5. Associated Foods: Raw meats, poultry, eggs, milk and dairy products, fish, shrimp, frog legs, yeast, coconut, sauces and salad dressing, cake mixes, cream-filled desserts and toppings, dried gelatin, peanut butter, cocoa, and chocolate. Various Salmonella species have long been isolated from the outside of egg shells. The present situation with S. enteritidis is complicated by the presence of the organism inside the egg, in the yolk. This and other information strongly suggest vertical transmission, i.e., deposition of the organism in the yolk by an infected layer hen prior to shell deposition. Foods other than eggs have also caused outbreaks of S. enteritidis disease. 6. Relative Frequency of Disease: It is estimated that from 2 to 4 million cases of salmonellosis occur in the U.S. annually. The incidence of salmonellosis appears to be rising both in the U.S. and in other industrialized nations. S. enteritidis isolations from humans have shown a dramatic rise in the past decade, particularly in the northeast United States (6-fold or more), and the increase in human infections is spreading south and west, with sporadic outbreaks in other regions. http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 7 of 314 Reported cases of Salmonellosis in the U.S. excluding typhoid fever for the years 1988 to 1995. The number of cases for each year varies between 40,000 and 50,000. From Summary of Notifiable Diseases, United States MMWR 44(53): 1996 (October 25). 7. Complications: S. typhi and S. paratyphi A, B, and C produce typhoid and typhoid-like fever in humans. Various organs may be infected, leading to lesions. The fatality rate of typhoid fever is 10% compared to less than 1% for most forms of salmonellosis. S. dublin has a 15% mortality rate when septicemic in the elderly, and S. enteritidis is demonstrating approximately a 3.6% mortality rate in hospital/nursing home outbreaks, with the elderly being particularly affected. Salmonella septicemia has been associated with subsequent infection of virtually every organ system. Postenteritis reactive arthritis and Reiter's syndrome have also been reported to occur generally after 3 weeks. Reactive arthritis may occur with a frequency of about 2% of culture-proven cases. Septic arthritis, subsequent or coincident with septicemia, also occurs and can be difficult to treat. 8. Target Populations: All age groups are susceptible, but symptoms are most severe in the elderly, infants, and the infirm. AIDS patients suffer salmonellosis frequently (estimated 20-fold more than general population) and suffer from recurrent episodes. http://www.cfsan.fda.gov/cgi-bin/printall.cgi 8/29/2007 Consolidated for printing: US FDA/CFSAN - Bad Bug Book: Introduction to Foodborne Pathogenic Microorganisms and Natural Toxi...Page 8 of 314 9. Foods Analysis: Methods have been developed for many foods having prior history of Salmonella contamination. Although conventional culture methods require 5 days for presumptive results, several rapid methods are available which require only 2 days. 10. Selected Outbreaks: In 1985, a salmonellosis outbreak involving 16,000 confirmed cases in 6 states was caused by low fat and whole milk from one Chicago dairy. This was the largest outbreak of foodborne salmonellosis in the U.S. FDA inspectors discovered that the pasteurization equipment had been modified to facilitate the running off of raw milk, resulting in the pasteurized milk being contaminated with raw milk under certain conditions. The dairy has subsequently disconnected the cross-linking line. Persons on antibiotic therapy were more apt to be affected in this outbreak. In August and September, 1985, S. enteritidis was isolated from employees and patrons of three restaurants of a chain in Maryland. The outbreak in one restaurant had at least 71 illnesses resulting in 17 hospitalizations.
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