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GS TS BS LÊ HOÀNG NINHBiên soạn theo tài liệu của CDC, FDA Hoa kỳ,center for food security and public healthNội dungOrganismsHistoryEpidemiologyTransmissionFoodborne illnessPrevention and Control Center for Food Security and Public Health Iowa State University 2004Vi sinh vậtEstimated 250 foodborne pathogensFoodborne illness2 or more cases of a similar illness resulting from ingestion of a common foodBacteria most common causeAlso viruses, parasites, natural and manufactured chemicals, and toxins from organismsCenter for Food Security and Public Health Iowa State University 2004Foodborne disease outbreaks, cases and deaths 1993-1997Salmonella had the highest numberCenter for Food Security and Public Health Iowa State University 2004HistoryEarly 1900’sContaminated food, milk and water caused many foodborne illnessesSanitary revolutionSewage and water treatmentHand-washing, sanitationPasteurization of milk- 1908Refrigeration in homes- 1913Center for Food Security and Public Health Iowa State University 2004HistoryAnimals identified as a source of foodborne pathogensImproved animal care and feedingImproved carcass processingSurveillance and researchOutbreak investigationsLaws and policies regarding food handlingCenter for Food Security and Public Health Iowa State University 2004Dịch tễFoodborne diseases each year in USAffects 1 in 4 Americans76 million illnesses325,000 hospitalizations5,000 deaths1,500 of those deaths caused by Salmonella, Listeria, and ToxoplasmaCenter for Food Security and Public Health Iowa State University 2004EpidemiologyMany unrecognized or unreportedMild disease undetectedSame pathogens in water and person to personEmerging pathogens unidentifiableGreatest riskElderlyChildren ImmunocompromisedCenter for Food Security and Public Health Iowa State University 2004Giám sát / luật lệSurveillanceCDC FoodNet and PulseNetRegulationFDADomestic and imported foodUSDA FSISMeat, eggs, poultryNational Marine Fisheries ServiceCenter for Food Security and Public Health Iowa State University 2004SurveillanceFoodNet: Active surveillanceEstablished 1996CDC, USDA, FDA, select state health departmentsNine sites in U.S. monitor 13% of U.S. populationCalifornia, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, Oregon, TennesseeCenter for Food Security and Public Health Iowa State University 2004SurveillancePulseNet: Identify causeMolecular fingerprinting45 state public health labs certifiedPassive surveillance: Survey methodsHospital dischargesOutpatient treatment facilitiesFoodBorne Disease Outbreak Surveillance SystemAll states submit outbreak dataCenter for Food Security and Public Health Iowa State University 2004Chi phí Economic Research Service - USDACost of top 5 foodborne pathogens$6.9 billion annuallyMedical costProductivity losses (missed work)Value estimate of premature deathCenter for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 2004TransmissionOral routeContamination variesOrganism, reservoir, handling/processing, cross-contaminationHuman reservoirNorwalk-like virus, Campylobacter, ShigellaAnimal reservoirCampylobacter, Salmonella, E. coli 0157:H7, Listeria, and ToxoplasmaCenter for Food Security and Public Health Iowa State University 2004TransmissionContamination can occur at several points along the food chainOn the farm or in the fieldAt the slaughter plantDuring processingAt the point of saleIn the homeCenter for Food Security and Public Health Iowa State University 2004Produce ProcessingCenter for Food Security and Public Health Iowa State University 2004 Important OrganismsNorwalk-like virusesCampylobacterSalmonellaE. coli O157:H7Clostridium botulinumShigella sppToxoplasmaEmerging organismsCenter for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 2004PathogenNo. of CasesSalmonella6,017Campylobacter5,215Shigella3,021Cryptosporidium480E. coli 0157443Yersinia161Listeria138Vibrio110Cyclospora15Total in 200315,600Center for Food Security and Public Health Iowa State University 2004MMWRCenter for Food Security and Public Health Iowa State University 2004MMWRCenter for Food Security and Public Health Iowa State University 2004Norwalk-like VirusesNorovirus; Caliciviridae familyMost common foodborne agent23 million cases annuallySourcesPerson-to-personShed in human feces, vomitusOutbreaks in daycares, nursing homes, cruise shipsContaminated shellfishCenter for Food Security and Public Health Iowa State University 2004Norwalk-like VirusesSmall infectious doseSigns12-48 hours post-exposureNausea, vomiting, diarrhea, abdominal crampsHeadache, low-grade feverDuration: 2 daysFood handlers should not return to work for 3 days after symptoms subsideCenter for Food Security and Public Health Iowa State University 2004Campylobacter jejuniLeading cause of bacterial diarrhea2.4 million people each yearChildren under 5 years oldYoung adults (ages 15-29)Very few deathsCan lead to Guillain-Barré SyndromeLeading cause of acute paralysis Develops 2-4 weeks after Campylobacter infection (after diarrheal signs disappear)Center for Food Security and Public Health Iowa State University 2004CampylobacteriosisSources Raw or undercooked poultryNon-chlorinated waterRaw milkInfected animal or human fecesPoultry, cattle, puppies, kittens, pet birdsClinical signsDiarrhea, abdominal cramps, fever, nauseaDuration: 2-5 daysCenter for Food Security and Public Health Iowa State University 2004SalmonellosisGram negative bacteriaMany serotypes can cause diseaseS. enteritidis and typhimurium41% of all human cases Most common species in U.S. 1.4 million cases annually580 deathsCenter for Food Security and Public Health Iowa State University 2004SalmonellosisSourcesRaw poultry and eggsRaw milkRaw beefUnwashed fruit, alfalfa sproutsReptile pets: Snakes, turtles, lizardsSignsOnset: 12-72 hours Diarrhea, fever, crampsDuration: 4-7 daysCenter for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 20041972 1977 1982 1987 1992 1997 2002Year302520151050Salmonellosis. Reported cases per 100,000 population, by year – U.S., 1972-2002MMWRMost common serotypes:S. typhimurium, S. enteriditis, S. NewportRateE. coli O157:H7Enterohemorrhagic Escherichia coli (EHEC)Surface proteins; toxinSourcesUndercooked or raw hamburger; salamiAlfalfa sprouts; lettuceUnpasteurized milk, apple juice or ciderWell waterAnimals: Cattle, other mammalsCenter for Food Security and Public Health Iowa State University 2004E. coli O157:H7SignsWatery or bloody diarrhea, nausea, crampsOnset: 2-5 daysDuration: 5-10 daysSequela Hemolytic Uremic Syndrome (HUS)Acute kidney failure in childrenLife threateningCenter for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 2004MMWRBotulismClostridium botulinumNeurotoxin leads to flaccid paralysis Infants at greatest riskAnnually: 10-30 outbreaks; ~110 casesSources: Home-canned  foods, honeySignsDouble vision, drooping eyelids, difficulty speaking and swallowingOnset: 18-36 hoursCenter for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 2004Year 1982 1987 1992 1997 2002 Reported Cases1101009080706050403020100MMWRShigellosisBacillary dysenteryMost cases Shigella sonnei90,000 cases every year in U.S.Sources:Human fecal contamination of food, beverages, vegetables, waterSigns:Watery or bloody diarrhea, nausea, vomiting, cramps, feverOnset: 2 daysDuration: 5-7 daysCenter for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 2004Year 1972 1977 1982 1987 1992 1997 2002 Rate151050MMWRToxoplasmosisToxoplasma gondii- intracellular protozoan112,500 cases annuallyPregnant women/immunocompromised at greatest risk SourcesInfected cats, soil, undercooked meatSignsFever, headache, swollen lymph nodesCenter for Food Security and Public Health Iowa State University 2004Emerging PathogensCyclospora (Protozoan)1996, imported raspberriesListeria monocytogenesSourcesReady-to-eat meats, soft cheesesSignsHuman abortions and stillbirthsSepticemia in young or low-immune Center for Food Security and Public Health Iowa State University 2004Center for Food Security and Public Health Iowa State University 2004HACCPHazard Analysis Critical Control PointTo monitor and control production processesIdentify food safety hazards and critical control pointsProduction, processing and marketingEstablish limitsMonitorApplied to meat, poultry, and eggsCenter for Food Security and Public Health Iowa State University 2004On Farm StrategiesTesting and removal for SalmonellaSerologic, fecal culture, hide cultureVaccinating Many serotypesVarying effectivenessMinimize rodents, wild birdsIsolation of new animalsCenter for Food Security and Public Health Iowa State University 2004At the Slaughter PlantFSIS target organismsSalmonella and E. coliControl points Removal of internal organsMinimize contact between carcassesProper movement through facilities Chilling Cooking processes (time, temperature)Center for Food Security and Public Health Iowa State University 2004IrradiationUsed since 1986 for Trichina control in porkGamma raysPoultry in 1990/1992Meat in 1997/1999Reduction of bacterial pathogensKills living cells of organismsDamaged and cannot surviveCenter for Food Security and Public Health Iowa State University 2004IrradiationIdentified with radura..Does not affect taste qualityNutrients remain the sameHandle foods appropriately afterwardsDoes not sterilizeContamination can still occurCenter for Food Security and Public Health Iowa State University 2004USDA Recall ClassificationCenter for Food Security and Public Health Iowa State University 2004In the HomeDrink pasteurized milk and juicesWash hands carefully and frequentlyAfter using the bathroomChanging infant’s diapersCleaning up animal fecesWash hands before preparing foodCenter for Food Security and Public Health Iowa State University 2004Tại nhà Wash raw fruits and vegetables before eatingAfter contact with raw meat or poultryWash hands, utensils and kitchen surfacesHot soapy waterDefrost meats in the refrigeratorCenter for Food Security and Public Health Iowa State University 2004In the HomeCook beef/beef products thoroughlyInternal temperature of 160oFCook poultry and eggs thoroughlyInternal temperature of 170-180oFEat cooked food promptlyRefrigerate leftovers within 2 hours after cookingStore in shallow containersCenter for Food Security and Public Health Iowa State University 2004Additional ResourcesCenters for Disease Control and Prevention Department of Agriculture for Food Security and Public Health Iowa State University 2004