Types of Food-Borne Illnesses

There are many different infectious diseases that humans can acquire through the consumption of food, water or beverage products which are contaminated with various types of microbial organisms. Most types of foodborne illness are caused by bacterial pathogens such as Escherichia coli, Salmonella, Listeria, Campylobacter, Shigella or Clostridium botulinum. Others such as Hepatitis A or Noroviruses are caused by viral pathogens. Certain parasites can also cause foodborne illnesses such as Toxoplasmosis. Many cases of food poisoning are relatively isolated incidents involving a single individual or a small number of people who are usually part of a family or other group. However, there are instances of widespread outbreaks of food poisoning which affect many members of the consuming public. Most outbreaks of foodborne illness involve foods contaminated with E. coli or Salmonella pathogens. Humans need only consume a very small number of E. coli or Salmonella bacteria to become infected and suffer illness. Ingestion of the E. coli pathogen can lead to infection, E. coli poisoning and, in some severe cases, a condition known as Hemolytic Uremic Syndrome (HUS). Ingestion of Salmonella bacteria can lead to infection and resulting illness referred to as Salmonellosis. These two foodborne illnesses are discussed in our Food Poisoning Practice Center. Other food borne illnesses, including Listeriosis, Camplyobacteriosis, Sigelliosis, Botulism, Hepatitis A, Noroviruses and Toxoplasmosis, are discussed below:

Overview of Food Poisoning Due to Listeria

Listeriosis is a bacterial infection caused by the bacterium Listeria monocytogenes. It is especially dangerous for pregnant women because it can lead to miscarriage or still birth, premature delivery and/or infection of the newborn. Because Listeria monocytogenes is an intracellular pathogen, anyone with a depressed cell-medicated immune system (especially pregnant women, fetuses and newborns) are most susceptible to becoming ill after exposure to this organism. Pregnant women are about 20 times more likely to suffer Listeriosis than other healthy adults and, as a result, about one-third of all Listeria infections occur during pregnancy. Other persons at higher risk include the elderly, patients with cancer, diabetes, kidney disease or AIDS, persons with depressed immune T cells such as transplant recipients and lymphoma patients, and persons who take glucocorticosteroid medications. This pathogen has a long incubation period (3-70 days) and most persons remain symptom free for several days to several weeks after exposure. The initial symptoms in adults are usually fever, muscle aches, nausea and diarrhea. In newborns, additional symptoms include jaundice, lethargy, skin rash, loss of appetite, vomiting and difficulty breathing. If the infection spreads to the central nervous system, headache, stiff neck, lack of balance, confusion or disorientation, convulsion and stroke-like symptoms may develop. Listeria infections, including those suffered by pregnant females, are treatable with antibiotics. However, about 500 Americans die annually as a result of severe Listeria infections.

The Causes and Prevention of Listeria Infections and Illnesses

Listeria bacteria is very ubiquitous in the environment, meaning they can be found almost anywhere including in soil, untreated water, wild and domestic animals, birds and insects. Thus, many fruits, vegetables, meats and dairy products can become contaminated in a variety of ways (i.e. contact with soil, manure, host animals, etc.). Listeria is readily destroyed by heat so thorough cooking and pasteurization are the primary methods of preventing infection. However, Listeria can survive in low temperatures so refrigeration or freezing will not kill any organisms which survive undercooking or which contaminate prepared foods after cooking. Thus, Listeria infections are often traced to refrigerated ready-to-eat foods such as deli meats, hotdogs and other prepared products where the bacteria were allowed to grow while the food was maintained in a refrigerator. Pregnant women and other persons at higher risk should avoid hotdogs, cold cuts and deli meats (unless thoroughly reheated), unpasteurized milk or juices, various soft-ripened cheeses or any cheese made with unpasteurized milk, refrigerated pates or meat spreads, and any refrigerated smoked seafood.

Overview of Food Poisoning Due to Campylobacter

Campylobacteriosis is the most common bacterial foodborne illness in the United States. There are numerous species of the Campylobacter bacteria, but most human illness is caused by the bacterium Campylobacter jejuni which naturally resides in the intestines of warm blooded animals and birds. Symptoms of diarrhea (sometimes bloody), abdominal pain or cramping, nausea, vomiting and fever (in some cases) usually appear within 2-5 days of exposure. The majority of cases resolve within a few days to a week, although infrequently the infection spreads to the blood stream causing sepsis and death in rare instances. Campylobacteriosis is associated with just over 100 deaths in this country annually, but most of these cases involve patients who are immunocompromised. Also, Campylobacter infection can lead to a rare but serious neurological disease called Guillain-Barre Syndrome, but this occurs in less than 1% of all cases. Thus, while the number of Campylobacter infections is very high, the incidence of death or serious complications is very low.

The Causes and Prevention of Campylobacter Infections and Illnesses

Most infections result from the consumption of poultry or other meat products contaminated with the Campylobacter pathogen due to contact with animal feces during slaughter and/or subsequent processing. Chicken is the most common food implicated, although other potential food sources include undercooked turkey, duck, game fowl, beef, pork, lamb and other meats (and/or the juices of the same), eggs, unpasteurized milk, and fresh produce. Campylobacter infections occur frequently in part because a very small number of organisms can cause illness in humans. Thus, even one drop of juice from raw chicken can cause food poisoning. Fortunately, Campylobacteriosis usually occurs as an isolated event and not as part of a widespread outbreak. Consumers can reduce the risk of infection by adequately cooking any raw poultry or other meat, and using safe food handling practices to avoid cross contamination.

Overview of Food Poisoning Due to Shigella

Shigellosis (also called “bacillary dysentery”) is a highly contagious bacterial infection caused by various pathogens known as Shigella. Symptoms usually occur within 1-3 days and include diarrhea (sometimes bloody), abdominal cramps or pain, nausea, vomiting, rectal tenesmus, and sometimes fever. Antibiotics can sometimes be effective in lessening the duration and/or severity of the illness. Most cases resolve within a week and usually do not require hospitalization or cause any significant complications. However, Shigella infections can lead to rectal bleeding, severe dehydration and/or fevers requiring hospitalization. Severe cases of Shigellosis can lead to reactive arthritis (“Reiter’s Syndrome”), high fever and seizures in children, Hemolytic Uremic Syndrome, sepsis and death, although these outcomes are relatively infrequent. Children tend to be the most susceptible to Shigella infections, and numerous outbreaks have involved daycare centers.

The Causes and Prevention of Shigella Infections and Illnesses

Shigella bacteria thrive in the intestines of humans. Therefore, transmission is primarily by person-to-person contact. Ultimately, the source is fecal matter from an infected individual and transmission occurs via the hand-to-mouth route, which is why thorough hand washing is a critical part of preventing this illness. Shigella bacteria can remain active for weeks so those who are sick can still transmit the infection well after they seemingly recover. Food borne transmission can occur when food is prepared in unsanitary conditions or by persons currently or previously infected. Contamination of vegetables has also occurred where they were harvested from a field containing sewage or human stools left by workers who defecated. Water borne transmission can also occur when wells, shallow ponds, pools or water parks become contaminated with human excrement. Heat will destroy Shigella bacteria so adequate cooking – along with hand washing and good sanitation practices – helps prevent infection. Individuals suffering Shigallosis (or any diarrhea) should not be allowed to prepare food for other people. Children not yet toilet trained or who have diarrhea should be excluded from pools, water parks or other public swimming areas.

Overview of Food-Borne Botulism

Botulism is a rare but very serious muscle paralyzing illness caused by a nerve toxin (poison) produced by bacteria called clostridium botulinum commonly found in soil and marine sediments. It is not a communicable disease so it does not spread from person to person. Persons can suffer Botulism by consuming contaminated foods containing the neurotoxin (food-borne botulism) or having an open wound infected by the C. botulinum pathogen (wound botulism). There is a third type (infant botulism) that occurs in infants (usually age 1 or younger) who have ingested the spores of the bacteria which then colonize in their intestines and release the toxin. All three types of botulism are potentially fatal and should be considered medical emergencies requiring immediate medical attention. Any case of food-borne botulism should be considered a public health emergency because many people can be poisoned by eating even a minuscule amount of a neurotoxin contaminated food. Therefore, identification of the potential food source is critical in preventing the worsening of a botulism outbreak. The classic symptoms include blurred or double vision, drooping eyelids, dry mouth, impaired speech, muscle weakness and shortness of breath. In infants, the symptoms can also include constipation, weak cry, floopy or weak movement, and lethargy. Sickness usually begins within 12-36 hours after contaminated food is consumed. Fortunately, less than 150 new cases of botulism are typically reported to the CDC each year. Of these, approximately 65% are infant botulism, 20% are wound, and the remaining 15% are food borne.

The Causes and Prevention of Botulism

The most common food sources are home canned vegetables (especially those with low acid content such as carrots, asparagus, green beans, beats and corn) because the bacteria are anaerobic, meaning they thrive and continue to produce the harmful toxin in low oxygen environments. Indeed, Clostridium botulinum form spores which allow the bacteria to survive in a dormant state until exposed to conditions that can support growth. Commercially produced canned goods are rarely implicated because of proper cooking and canning procedures. Other known food borne sources include home canned or uncooked fermented seafood, oils infused with garlic and other herbs, chili peppers, tomatoes and baked potatoes wrapped in aluminum foil which were allowed to cool significantly before being eaten. Honey is safe for adults, but it can cause infant botulism in babies. Therefore, honey should never be given to infants younger than one year. Other precautions include proper cooking and preparation of all home canned and preserved foods, refrigerating oils infused with garlic and other herbs, keeping wrapped baked potatoes hot until served, boiling all canned foods before eating, and avoiding any canned foods where the can is bulging or there is any puncture or other opening.

Overview of Food-Borne Hepatitis A

Hepatitis A is a communicable infectious disease caused by the Hepatitis A virus (HAV) which primarily affects the liver. Hepatitis A is the only food borne illness that can be prevented by a vaccine. Indeed, HAV immunization and advanced sanitation systems are the primary reasons the incidence of Hepatitis A is relatively low in the United States as compared to other lesser developed countries. Yet, as many as 50,000 new cases still arise in this country every year with about 10-12% resulting in hospitalization. Unlike Hepatitis B and C, Hepatitis A does not develop into chronic hepatitis or liver cirrhosis. Instead, it is an acute viral infection that usually causes the liver to be swollen and inflamed for several weeks or months, but this usually resolves without any long term damage. However, in rare instances, Hepatitis A can cause acute liver failure and death. The HAV virus has a prolonged incubation period (usually around 2-4 weeks) followed by an acute period during which the affected person is contagious and can transmit the infection to other persons. Symptoms can include nausea, vomiting, loss of appetite, fever, fatigue, darkened urine, jaundice and right-upper abdominal pain. There is no cure or treatment for Hepatitis A. Fortunately, persons who have suffered Hepatitis A will thereafter have a life long immunity to it.

Overview of Food Poisoning Due to Toxoplasma

Toxoplasmosis is a potentially dangerous infection caused by a microscopic parasite known as Toxoplasma gondii. Causing nearly 400 fatalities per year, Toxoplasmosis is considered to be the third leading cause of death from foodborne illness in the United States. Toxoplasmosis is especially dangerous for pregnant women because the parasite can invade the placenta and sometimes pass to the unborn child (congenital infection). Transmission of the parasite to the unborn child can take place (referred to as “congenital Toxoplasma”) even where the mother has no symptoms and is unaware that she is acutely infected. The risk of congenital infection is about 15% for maternal infections which occur during the first trimester. The risk rises later in pregnancy (30% in the second trimester, and 60% in the third trimester). Congenital infection can threaten the health of the fetus and sometimes cause severe diseases of the eyes and nervous system. Adverse health consequences to the unborn child are often more severe the earlier in pregnancy congenital transmission occurs. However, if maternal infection occurs months before inception, then the fetus is usually protected because of immunity developed by the mother. As a result, some experts recommend that women who have suffered Toxoplasma infections wait 6 months or more before becoming pregnant. Infants infected during gestation may show no symptoms after birth but develop vision loss, seizures or mental disability later in life. Toxoplasma infection during or shortly before pregnancy can also result in miscarriage or birth of a stillborn child.

Most pregnant women and other healthy adults will not suffer any symptoms and will not even know they have become infected with the parasite. Sometimes, healthy adults may experience mild flu-like symptoms which resolve within a few days or weeks. However, the parasite will remain in the body in an “inactive” state. About one-quarter of the United States population has been infected with this parasite. Most previously infected individuals never knew they had the parasite, and they are unaware that it lies dormant in their tissue. Unfortunately, the parasite can become “reactivated” and cause a “relapse” of Toxoplasmosis especially where there arises some compromise of the previously infected person’s immune system. The vast majority of deaths and severe health consequences from Toxoplasmosis involve pregnant women, infants infected in utero, and adults who are immunocompromised. Antibiotics can be used to treat Toxoplasma infections. Indeed, the earlier antibiotic therapy is started, the greater chance transmission to the fetus can be avoided.

Obtain Legal Advice About Food Poisoning and Food-Borne Illnesses
From a Georgia Food Safety Litigation Attorney

The Atlanta-based lawyers at Ragland & Jones, LLP have expertise in the litigation of cases involving issues of food safety, food poisoning and foodborne illness. They are capable of pursuing claims and lawsuits in Georgia, Alabama, Florida, Tennessee, South Carolina and other states on behalf of persons who have suffered E. coli, Salmonella, Listeria, Toxoplasma, Hepatitis A or other infections caused by contaminated or negligently prepared food, water or beverage products. We invite you to Contact us if you or a family member has been the victim of food poisoning and desire legal advice from a lawyer who specializes in food safety litigation.