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794 Part 8: Food Safety and Food Allergens
Outbreaks of food and waterborne illness have been reported in
the United States and the United Kingdom (Craun 1990, Porter
et al. 1990). Infection with this parasite is associated with unsan-
itary conditions, and contaminated water is the most common
source of infection.
Foodborne Fungi
Fungi most commonly associated with foodborne intoxica-
tions arePenicillium, Aspergillus,andFusarium. The types of
foods that may contain mycotoxin contamination are listed in
Table 41.3. A foodborne fungi outbreak associated with con-
sumption of corn contaminated withAspergillus flavuswas re-
ported in India. The outbreak involved 1000 cases and 100 deaths
(Krishnamachari et al. 1975). Mold growth can occur in foods
stored under high temperature or humidity, resulting in the pro-
duction of mycotoxin, which can be harmful to humans.
Foodborne Virus Infection
Viruses from human fecal origin can result in illness if ingested
with food or water. Food or waterborne viruses commonly as-
sociated with human illness are listed in Table 41.3. Viral gas-
troenteritis is caused by Norwalk-like viruses and in some cases
by the calicivirus and astrovirus groups. The symptoms often
include acute but short self-limiting episode of diarrhea and
vomiting. The viruses can be transmitted from person to person
via contaminated utensils and foods. Foodborne viral hepatitis
in humans is caused by the hepatitis A or hepatitis E virus. The
onset of hepatitis may be preceded by anorexia, fever, fatigue,
nausea, and vomiting. Infected individuals shed the organism in
feces, which if allowed to contaminate food or water, can result
in person-to-person transmission (Caul 2000).
EMERGING PATHOGENS AND
FOOD SAFETY
Emerging infectious diseases have increased in the last two
decades and are likely to increase in the future. Hence, the
characteristics of the etiologic agents of these diseases must
be considered when designing control measures to ensure food
safety. There are two types of emergence: true emergence and
reemergence. A true emergence involves the occurrence of mi-
crobial agent not previously identified as a public health threat. A
reemergence involves the occurrence of a microbial agent caus-
ing disease in a new way not previously reported or the reemer-
gence of a human disease after a decline in incidence. Emergence
may be due to the introduction of a new agent, to recognition
of an existing disease that was not previously detected, or to
environmental pressures resulting in occurrence of a pathogen
that can cause human disease. For example, the occurrence of
enterohemorrhagicE. coliO157:H7 as a pathogen in 1982 is
believed to be due to introduction of a new agent. The organism
was involved in two outbreaks that year in the United States,
and these outbreaks were associated with consumption of un-
dercooked hamburgers from a fast-food restaurant chain. Several
countries worldwide have reported outbreaks of infection caused
Table 41.4.Emerging Pathogens and Suspected
Causes of Emergence
Pathogens Cause of Emergence
SalmonellaDT104 Resistance to antibiotics
E. coliO157:H7 Development of a new pathogen
Cyclospora cayetanensis Development of a new pathogen
Cryptosporidium parvum Development of a new watershed
areas
Hepatitis E virus Newly recognized
Norwalk Virus Increased recognition
AeromonasSpp. Immunosuppression and
improved detection
C. jejuni Increased recognition,
consumption of uncooked
poultry
L. monocytogenes Increased awareness
Helicobacter pylori Increased recognition
Vibrio vulnificus Increased recognition
by this organism. The appearance ofSalmonella typhimurium
phage type 104 is another example of a new agent. Increases
in the use of antibiotics in humans and animals may have pro-
vided the environmental pressures resulting in the occurrence
ofSalmonella typhimuriumphage type 104 with multiresistance
to five antibiotics: ampicillin, chloramphenicol, streptomycin,
sulphonamides, and tetracycline. This multiresistant character-
istic leaves little choice of antibiotics for treatment of disease
caused by this organism. The occurrence ofListeria monocyto-
genesas a foodborne agent is an example of reemergence. The
organism is a well-known infectious agent; however, its role as a
foodborne organism was not detected until the early 1980s. Ex-
amples of emerging foodborne pathogens and possible causes of
emergence are provided in Table 41.4. The challenge posed by
the appearance of emerging pathogens is that these organisms
may not always behave as traditional pathogens. Therefore, new
control measures to ensure that foods are free of these pathogens
may be required.
CONTROL MEASURES FOR MICROBIAL
CONTAMINANTS
A combination of factors is normally responsible for occurrence
of an incident of foodborne illness. The pathogen must first
reach the food involved; the organism must survive until food is
ingested; in many cases, the organism must multiply to an infec-
tious level or produce toxins; and lastly, the host must be suscep-
tible to the level of organisms ingested with the food. Control
measures to ensure food safety include (1) prevention of con-
tamination of foods by pathogenic organisms (2) inhibition of
growth or elimination of pathogens in foods and food products.
The first stage of control measures is to prevent contamination of
food animals and plants during the production stage. Production
practices such as the use of manure and other organic fertil-
izer materials can provide the vehicle for contamination of food