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Five keys

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  • 1. 1.INTRODUCTIONFood borne diseases-(intoxications and infections) covers illnesses acquired through consumption of contaminated food-i.e food poisoningFood borne disease outbreaks-occurrence of 2 or more cases of similar illness resulting from ingestion of common food OR when observed number of paticular disease exceeds expected numberMost cases-sporadic but need investigations for control
  • 2. 1.INTRODUCTION –BURDENGlobal burden-high morbidity and mortalityInfectious diarrhoea-3 to 5 billion cases and 1.8 million deaths annuallyCDC-76 million cases of food borne diseases in US annually with appx.5000 deaths
  • 3. FOOD BORNE INFECTIONS VS INTOXICATIONInfections- Intoxications-toxins Bacterial/Viral/parasite (natural/preformed bacterial/chemical)Invade and or multiply in lining of intestine No invasion or multiplicationIncubation period-hours to Incubation period-minutes to days hourss/s-diarrhoea,nausea,vomitting, s/s- vomitting,nausea,diarrhea,diabdominal cramps,fever plopia,weaakness,resp.failurTransmission-spreads from e,numbness,sensory/motor person to person dysfunctionFactors-inadequate Not communicable cooking,cross Factors-inadequate contamination,poor personal cooking,improper handling hygiene,bare hand contact temperatures
  • 4. SOME IMPORTANT FOOD-BORNEPATHOGENS,TOXINS ANDCHEMICALS1.Bacteria-Bacillus cereus,brucella,campylobacter,clostridium sp,e.coli,Salmonella sp,listeria,staph aureus,,vibrio cholera and parahemolyticus2.viruses-hepatitis a and e,rotavirus,norvovirus,3.protozoa- cryptosporidium,cyclospora,entamoeba,giardia,t gondii4.trematodes,cestodes and nematodes
  • 5. FOOD BORNE PATHOGENS- TOXINS AND CHEMICALSToxins-marine biotoxins,tetrodotoxin(pufferfish),pyrrolizidine alka,mushroom toxins,shellfish toxins,mycotoxins,plant toxicantsChemicals-pesticides(opp,sb),radionuclides,nitrites(food preservatives),toxic metals- cd,cu,hg,pb,sn,fluoride,MSG
  • 6. PATHOGENESIS AND TRANSMISSIONInfectious agent or contaminantInoculum/size of infective dose-can be as small as 10-100 bacterial cysts for shigella,EHEC,giardia,E.histolytica or 10^ 5- 10^ 8 for vibrio cholera,variable for salmonellaAnimals or humans harbouring infectionshed in fecescontaminate water,fruits,vegetablesinadequate cooking/improper storageinfectionWarm temperature(10-50 degree cent.)- multiplication of pathogens
  • 7. SOME COMMON BACTERIAL FOODPOISONSIncubation cause symptoms Commonperiod foods1-6 hours Staph Nausea,vo Milk n milk aureus(ent mitting,diarr products,ha erotoxin) hea m,poultry,s alads,custa rds Bacillus Nausea,vo Fried rice cereus(ent mitting,(em erotoxin) etic form)
  • 8. SOME COMMON BACTERIAL FOOD POISONSIncubation Cause symptoms Commonperiod foods8-16 Clostridium Abd.cramps, Meat,hours perfringes diarrhea poultry, (spores) Nausea and legumes. vomitting-rare gravies Bacillus Diarrhea,abd. cereus(diarrhe pain,nausea, al form- No preformed n vomitting/fever stable toxins)
  • 9. SOME COMMON BACTERIAL FOODPOISONSIncubation cause symptoms Commonperiod foods>16 hours Vibrio Rice watery Water and cholera stools ice creams,sea food Salmonella Inflammato Meat,milk n spp ry diarrhea milk products,po ultry Shigella sp dysentry Potato/raw eggs-salad
  • 10. EARLY DIAGNOSIS ANDINVESTIGATIONS1.Initial assessment of cases-Detailed clinical history including time of onset,duration of illness,symptoms,h/o travel,recent meals,cooking and refrigeration,details of others with similar complaints2.Detailed clinical examination-vitals and degree of dehydration,systemic signs
  • 11. LAB DIAGNOSISMain objectives-a)To confirm clinical diagnosis by isolation of causative agent from proper samples,eg- stool,vomitus/gastric aspirate,food specimensb)Ensure proper identification of diseasec)Determine causative agent if present in food sources with relevant epidemiological markers-eg Biotyping,serotyping,pcr,phage typing etc
  • 12. THE SOLUTION!!