Foodborne Infectious Diseases Research Articles

Factors Associated with Emergence and Spread of Cholera Epidemics and Its Control in Sarawak, Malaysia between 1994 and 2003

Cholera is a water and food-borne infectious disease that continues to be a major public health problem in most Asian countries. However, reports concerning the incidence and spread of cholera in these countries are infrequently made available to the international community. Cholera is endemic in Sarawak, Malaysia. We report here the epidemiologic and demographic data obtained from nine divisions of Sarawak for the ten years from 1994 to 2003 and discuss factors associated with the emergence and spread of cholera and its control. In ten years, 1672 cholera patients were recorded. High incidence of cholera was observed during the unusually strong El Nino years of 1997 to 1998 when a very severe and prolonged drought occurred in Sarawak. Cholera is endemic in the squatter towns and coastal areas especially those along the Sarawak river estuaries. The disease subsequently spread to the rural settlements due to movement of people from the towns to the rural areas. During the dry seasons when tributary gravity fed tap waters cease to flow, rural communities rely on river water for domestic use for consumption, washing clothes and household utensils. Consequently, these practices facilitated the spread of water borne diseases such as cholera. The epidemiologic and demographic data were categorized according to ethnic group, gender, occupation, and age of the patients. Large outbreaks occurred in north Sarawak (Bintulu, Miri, and Limbang) rather than the central (Kapit, Sarikei, Sibu)

TEMPERATURE CAN BE AN EFFECTIVE PREDICTOR FOR DENGUE FEVER OUTBREAK

ISEE-180 Introduction: Global climate change has been implicated in altered ecosystem and environmental quality, and resulted in, potentially, significant threat to human health. For instance, weather variability and climate change are known to impact on the dynamics of infectious diseases especially in waterborne, food-borne, and vector-borne infectious diseases, such as dengue fever, a disease presenting serious concerns in Taiwan on practically annual base. Aim: Our study was therefore aimed to examine the associations between the trends of general climate factors (e.g., temperature, rainfall, and relative humidity), and the reporting of dengue fever in Taiwan. Methods: Our study began by establishing and linking various databases, including infectious diseases case registry, weather parameters, demographic, and vector density for statistical analysis. Geographic information system (GIS) was used to map the geographic distribution of dengue fever in southern Taiwan, and its association with various climatic and environmental factors was examined since 1988, the year that dengue fever was designated as “reportable infectious disease” by the Communicable Disease Control Act in Taiwan. Results: Our findings indicated that the surveillance of domestic vector density could not predict the outbreak of dengue fever in Kaohsiung City, a hot spot for such disease in Taiwan. Yet, temperature appeared to be an effective indicator for predicting the disease outbreak. Analysis showed that when the monthly average temperature (Tmean) went higher than 27 °C, monthly average maximum temperature (Tmax) higher than 30°C and monthly average minimum temperature (Tmin) higher than 19°C in the previous month (Lag=1), the risk of the occurrence of minor outbreak (reporting case ≥17) will increase (OR=7.66, 6.70, and 4.99). Meanwhile, if the Tmean went higher than 27°C, Tmax higher than 30°C, and Tmin higher than 20°C in the previous month, the risk of occurrence of major outbreak (reporting cases ≥81) will also increase (OR=24.62, 11.65, 8.80) for the following month after adjusting for rainfall, and relative humidity. Discussion: Our study suggests that compared with the vector densities index, temperature is an effective predictor for an outbreak of dengue fever by using the case registry and environmental data from southern Taiwan. This finding supports, with quantitative information, the proposition that as the environment became warmer, dengue fever endemic in southern Taiwan would also be worsening. Further studies may focus on developing models to estimate the associations between climate change and extreme weather events and their impacts on geographical distribution patterns of similar infectious diseases. International comparisons could be made when the scenarios are properly characterized.

Foodborne Infections in France

To quantify the impact of foodborne diseases on health, and set priorities for data collection, prevention and control of these diseases, we compiled and analyzed information from surveillance systems and other sources on the morbidity and mortality due to foodborne infectious diseases in mainland France in the last decade of the 20th century. Illness due to 13 bacteria, two viruses, and eight parasites were studied. The number of foodborne infections, hospitalizations, and deaths were estimated from multiple data sources. For each agent, several estimates were derived from the different sources. Estimates were ranked according to their plausibility, based on an assessment of the validity of the data source, and are presented as a "plausible interval" consisting of a low and high estimate. We estimate that these pathogens caused 10,200-17,800 hospitalizations per year. Salmonella is the most frequent cause (5,700-10,200 cases), followed by Campylobacter (2,600-3,500 cases) and Listeria (304 cases). Toxoplasmosis accounts for the majority of hospitalizations (426 cases) attributable to the studied parasitic infections. The number of deaths related to foodborne infection was estimated between 228 and 691. Bacterial pathogens account for the majority (191 to 652) of deaths of which 92 to 535 are attributable to salmonellosis, ranking as the first cause of death, and 78 to listeriosis, the second cause. Salmonella, Campylobacter, and Listeria are the main causes of severe foodborne illness in France. For several pathogens, data are insufficient to derive exact estimates of the disease burden. Nevertheless, it has been possible to derive plausible estimates for the majority, and to rank them according to their impact on public health.

Transmission of infectious diseases during commercial air travel

SummaryBecause of the increasing ease and affordability of air travel and mobility of people, airborne, food-borne, vector-borne, and zoonotic infectious diseases transmitted during commercial air travel are an important public health issue. Heightened fear of bioterrorism agents has caused health officials to re-examine the potential of these agents to be spread by air travel. The severe acute respiratory syndrome outbreak of 2002 showed how air travel can have an important role in the rapid spread of newly emerging infections and could potentially even start pandemics. In addition to the flight crew, public health officials and health care professionals have an important role in the management of infectious diseases transmitted on airlines and should be familiar with guidelines provided by local and international authorities.

Enteroaggregative Escherichia coli: An emerging pathogen in children

Enteroaggregative Escherichia coli (EAEC) is an emerging pathogen that causes enteric and food-borne infectious diseases. Children throughout the world appear to be susceptible to EAEC infection. EAEC pathogenesis involves the following three stages: 1) adherence to the intestinal mucosa; 2) increased production and deposition of a mucus biofilm; and 3) mucosal toxicity due to inflammation and cytokine release. The HEp-2 cell adherent assay allows identification of EAECs characteristic aggregative or "stacked brick" adherence pattern. Antimicrobial treatment of children who develop an EAEC infection should be individually based. All children with EAEC diarrhea should receive adequate oral fluid hydration. For children who have persistent diarrhea and severe dehydrating illness despite having received adequate oral rehydration, antimicrobials may be initiated. Azithromycin and rifaximin have been shown to shorten the course of EAEC diarrhea in adults and probably represent the recommended antimicrobials of choice for children with severe or persistent illness. The objective of this review is to increase awareness of this important emerging pathogen and to discuss the epidemiology, pathogenesis, and pathogen and host factors associated with EAEC infection in children.

Studies of Foodborne Infectious Diseases in the United States

Studies of Foodborne Infectious Diseases in the United States

Enteroaggregative Escherichia coli: an emerging enteric pathogen.

Enteroaggregative Escherichia coli (EAEC) represents an emerging pathogen that causes enteric and food-borne infectious diseases. Subgroups in many populations throughout the world are susceptible to EAEC infection. EAEC pathogenesis involves adherence to the intestinal mucosa; increased production and deposition of a mucus biofilm; and mucosal toxicity due to inflammation and cytokine release. Due to the heterogeneity of EAEC strains and differing host immune responses, not all EAEC infections are symptomatic. Recent data suggest that individuals with a homozygous genotype -251 AA single nucleotide polymorphism (SNP), in the IL-8 promoter region, are more susceptible to EAEC diarrhea. The HEp-2 cell adherent assay allows identification of EAEC's characteristic aggregative or "stacked brick" adherence pattern. Antimicrobial treatment of individuals who develop EAEC diarrhea should be individually based. Ciprofloxacin and rifaximin, compared to placebo, have been shown to significantly shorten the course of diarrhea in patients who developed EAEC infection. The objective of this review is to increase awareness of this important emerging pathogen and to discuss the epidemiology, pathogenesis, and host-pathogen factors associated with EAEC infection.

Pathology of food-borne infectious diseases of the gastrointestinal tract: an update.

Although naturally occurring food-borne pathogens cause more than 76 million illnesses, 325,000 hospitalizations, and 5000 deaths annually in the United States, many more infections are unrecognized and unreported. In addition, mass production and distribution of food, on a global rather than a local scale, make it possible for localized instances of contamination to spread quickly to other states, provinces, and countries. Infectious organisms are often recovered by microbiological methods, but surgical pathologists may play a very valuable role in diagnosis. This review will focus on the diagnosis of food-borne infectious diseases of the gastrointestinal tract, including those that mimic other inflammatory conditions of the gut (such as ischemia or idiopathic inflammatory bowel disease); available diagnostic methods; and gastrointestinal infectious processes that pathologists should be aware of in terms of potential biologic weapons threats.

ADSA Foundation Scholar Award—An Integrated Science-Based Approach to Dairy Food Safety: Listeria monocytogenes as a Model System

Transmission of food- and milkborne pathogens often involves complex interactions among the pathogen, the environment, and one or multiple host species. A complete understanding of these interactions is critical to allow the development of science-based, effective intervention strategies for foodborne infectious diseases. This article summarizes our studies on the transmission, ecology, pathogenesis and population genetics of Listeria monocytogenes, which we have used as model for a food- and milkborne pathogen that infects multiple hosts and also has considerable ability to survive and multiply in nonhost environments. Application of molecular subtyping tools in conjunction with phenotypic characterization of selected strains has allowed us to define distinct L. monocytogenes subtypes and clonal groups that appear to differ in relevant phenotypic characteristics that may affect their abilities to be transmitted through food systems. For example, a genetic group designated as lineage I has been shown to be not only more common among human listeriosis cases than among animal cases, but lineage I strains also appear to show an increased in vitro ability to spread intracellularly from host cell to host cell. These findings are consistent with the fact that while genetically diverse strains may be classified to one bacterial species, these strains often differ from one another in important genetic and phenotypic characteristics. I thus propose that evolutionary- and molecular subtyping-based definitions of bacterial subtypes and clonal groups will provide critical insight into the microbial ecology of dairy food systems, including not only foodborne pathogens, but also organisms important for dairy fermentation and spoilage.

Foodborne disease in the new millennium: out of the frying pan and into the fire?

About four million cases of foodborne infectious disease occur annually in Australia; new foodborne pathogens, such as enterohaemorrhagic Escherichia coli, are emerging. Climate change, combined with changes in how we produce and distribute food and how we behave as consumers, have the potential to affect foodborne disease in the coming century. Foodborne disease outbreaks are now more far-reaching (and sometimes global) due to modern mass food production and widespread food distribution. There are strong seasonal patterns for Salmonella and Campylobacter infection in Australia. Global warming may increase the incidence of infections, such as salmonellosis, and diseases caused by toxins, such as ciguatera.

Durable and Regenerable Antibacterial Finishing of Fabrics with a New Hydantoin Derivative

Durable and regenerable antibacterial fabrics were prepared by using an innovative chemical technology employing a precursor biocidal agent, dimethylol dimethylhydantoin (DMDMH), in a chemical finishing process. The method resulted in significant add-on rates of hydantoin groups on cellulose and established a durable antimicrobial functionality, once the grafted heterocyclic compounds were chlorinated by diluted chlorine bleaching. Both cotton fabrics and polyester/cotton fabrics exposed to treatment baths containing from 2 to 10% of DMDMH acquired a powerful inactivating capacity against a wide range of food-borne and water-borne infectious disease agents. The biocidal functions are regenerable by regular laundry exposure to chlorine bleach and can withstand over 50 standard machine washes without appreciable deterioration. In addition to their powerful antimicrobial efficacy, the fabrics exhibited improved wrinkle resistance and maintained appropriate mechanical properties, making them ideal for medical and hygienic textile applications. In this article we report the results from biocidal tests and durability evaluations and provide data characterizing physical attributes of the treated fabrics.

Foodborne and waterborne infectious diseases

PREVIEWChanges in the makeup and eating habits of the US population, an increasingly complex system of food distribution, and less stringent surveillance for infectious agents are among the factors that have led to an alarming increase in foodborne and waterborne illnesses in recent years. Drs Prier and Solnick address these issues and suggest changes in public health programs and consumer behavior that can minimize future outbreaks.

Shiga Toxin-Producing Escherichia coli.

Shiga toxin-producing Escherichia coli (STEC) are emerging as a significant source of foodborne infectious disease in the developed world. Multistate outbreaks of E. coli O157 and non-O157 serogroups in the United States are facilitated by the centralization of food processing and distribution. Our ability to recognize the clonality of these clusters has been advanced by developments in molecular detection techniques and in the establishment of active surveillance practices. These studies have helped identify important risk factors for both sporadic and outbreak STEC infection, allowing us to develop appropriate prevention strategies. Identification of these factors is of critical importance because of the lack of adequate treatments available. This brief review of the literature discusses major developments in the epidemiology, pathogenesis, diagnosis, treatment, and prevention of STEC disease published in the past few years.

Economic aspects of food-borne outbreaks and their control.

This paper begins with a discussion of the definition of an outbreak. It considers the portion of outbreaks in the general pattern of food-borne infectious disease. The methods used to identify outbreaks are described and the importance of the potential benefits and the economic impact of outbreak recognition and control and are discussed. The paper concludes by illustrating the economic impact of intervention using three infectious diseases botulism, Salmonella and Escherichia coli O157 as case studies of outbreaks.

New approaches to surveillance and control of emerging foodborne infectious diseases.

New approaches to surveillance and control of emerging foodborne infectious diseases.

Age-dependent resistance factors in the pathogenesis of foodborne infectious disease.

With increasing age there is an increase in both the incidence as well as the mortality due to many infectious illnesses, and foodborne infectious disease is no exception. A review of the pertinent literature identified studies concerning foodborne disease caused by infectious agents in the elderly, as well as those factors that could account for the increase in morbidity and mortality seen in the elderly due to foodborne infections. The published information suggested that the basis for the increased incidence, severity and risk of death of many foodborne infectious diseases in elderly persons is related to factors such as reduced gastric acidity, a higher prevalence of underlying medical disorders (co-morbidity factors), and immune system changes that result in a less effective host defense against infectious agents. The greater risk of foodborne disease experienced by elderly persons results from the contribution of non-immune and immune mediated factors. Due to the growing number of persons over the age of 65 years in the United States, foodborne disease in this age group will continue to be an important source of illness and death in the population.

Modeling disease transmission and its prevention by disinfection

Preface 1. The transmission and prevention of disease C. J. Hurst and P. A. Murphy 2. Strategies for modeling microbial colonization of the human body in health and disease R. A. Ross and M T Lee 3. Role of pathogen monitoring in microbial risk assessment J. B. Rose, J. T. Lisle and C. N. Haas 4. Estimating the risk of acquiring infectious disease from ingestion of water C. J. Hurst, R. M. Clark and S. E. Regli 5. Bacterial resistance to potable water disinfectants M. H. Stewart and B. H. Olson 6. Preventing foodborne infectious disease C. J. Hurst 7. Disinfection of microbial aerosols S. Clark and P. Scarpino 8. Transmission of viral infections through animate and inanimate surfaces and infection control through chemical disinfection S. A. Sattar and V. S. Springthorpe 9. The role of chemical disinfectants in controlling bacterial contaminants on environmental surfaces D. J. Gaber, T. M. Cusack and E. Scott 10. Sterilization and disinfection of medical devices A. B. Margolin and V. C. Chamberlain 11. Ultraviolet light disinfection of water and wastewater P. F. Roessler and B. F. Severin 12. Thermal inactivation of microorganisms G. Le Jean and G. Abraham Index.

The Epidemiology of Foodborne Disease in England and Wales in the 1980s

An epidemic of salmonellosis due to Salmonella enteritidis phage type 4 (PT4), a rise in Campylobacter enteritis, the detection of foodborne transmission in some cases of listeriosis and a large outbreak of botulism in north-west England and Wales were much publicized events in foodborne infectious disease in Britain in 1989. However, other changes took place in the 1980s which attracted less public attention; outbreaks of viral foodborne disease became more common, haemorrhagic colitis was first recorded, yersiniosis and infections caused by Aeromonas spp. increased, cryptosporidiosis and giardiasis came into prominence, and the major foodborne diseases of the past remained rare and usually imported. This article describes the surveillance of foodborne disease and reviews briefly these recent changes with particular reference to England and Wales, under four main headings: increasing foodborne infections, emerging foodborne infections, foodborne intoxications and ‘old’ foodborne diseases, updating a previous review (Galbraith et al., 1987).

Microbial Pathogens in Raw Pork, Chicken, and Beef: Benefit Estimates for Control Using Irradiation

Various control procedures have been suggested for reducing foodborne infectious diseases. Receiving considerable attention is irradiation. This report estimates the medical and wage (or productivity) benefits associated with prevention of five human diseases transmitted by beef, pork, and chicken. (These diseases can also be transmitted by other vectors, such as eggs, milk, and pets. But these sources are not included in the analysis.) All of these foodborne infectious diseases - salmonellosis, campylobacteriosis, trichinosis, tapeworm, and toxoplasmosis - could be significantly reduced by irradiating meat and poultry. The Food and Drug Administration (FDA) has just approved irradiation of pork to prevent trichinosis (50FR 29658-59) and is considering approval of irradiation of chicken to kill Salmonella. 22 references.