Food Borne Diseases and Food Safety

Food Borne Diseases and Food Safety

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Food Borne Diseases and Food Safety Introduction

  • Food safety can be compromised at any stage from the farm (where food is grown) to the fork (when it is consumed)
  • Food can easily become unsafe when we do not follow hygienic Cleaning principles during its transport, storage, cooking, and serving of food and food items

Objectives of Food Safety:-

  • Recognize, assess and classify different food-borne diseases
  • Investigate food poisoning cases/outbreaks
  • Describe preventive and control measures for food-borne diseases
  • Identify the signs and symptoms of food poisoning and refer for management
  • Identify the measures to be taken at various levels to ensure food safety
  • Make people aware of practicing the five keys to safer food
  • Describe the food storage, food handling, and cooking

What is Food borne diseases

  • The illnesses resulting from the ingestion of food contaminated with microorganisms (bacteria, viruses, parasites, etc) or harmful chemicals (toxins)
  • The contamination may occur at any stage in the process from food production to consumption
  • An estimated 600 million – almost 1 in 10 people in the world – fall ill after eating contaminated food and 420 000 die every year
  • Children under 5 yrs age carry 40% of the FBD burden

Causes of Food Borne Diseases

  • Bacteria – Salmonella, Campylobacter, Escherichia coli, Vibrio cholera, Listeria, Staphylococcus
  • Virus – Norovirus, Rotavirus, Hepatitis A and E virus, and other viruses.
  • Parasites – Entamoeba histolytica, Giardia lamblia, Cryptosporidium, Fish- borne
  • Toxins – Mycotoxins (e.g. aflatoxins), Marine biotoxins, Mushroom toxins,
  • Chemicals – Pesticides, Polychlorinated biphenyls (PCBs) Heavy metals (lead, cadmium, mercury, copper) Nitrites

Classification of Food Borne Diseases

  • Food-borne infections – Caused by microorganisms
  • Food-borne intoxications – Caused by toxins and chemicals

Differences between Food-borne Infections and Intoxication

Infections Intoxication
Cause Bacteria / Viruses /Parasites Toxins/Chemicals
Mechanism Invade and/or multiply within the lining of the intestines No invasion or multiplication
Incubation period Hours to days Minutes to hours
Symptoms Diarrhea, Nausea / Vomiting, Abdominal cramps, and/or Fever Vomiting, Nausea, Diarrhoea, Double vision, Weakness Respiratory failure, Numbness, Sensory and motor dysfunction
Transmission Can spread from person to person via the Falco-oral route Not communicable
Factors for food contamination Inadequate cooking, Cross-contamination, Poor personal hygiene, Bare hand contact Inadequate cooking, Improper holding temperatures

 

Signs and Symptoms of Foodborne Disease:-

  • Abdominal cramps
  • Diarrhea (bloody)
  • Nausea
  • Vomiting, Fever, Headache, Fatigue, Body aches

Transmission of Food-Borne Pathogens and Toxins

  1. Food production and processing –
    • Foods get contaminated if washed or irrigated with water that is contaminated with pathogens from animal or human feces
    • Animals naturally harbor many food-borne bacteria in their intestines that can cause illness in humans
    • During slaughter, meat and poultry carcasses can become contaminated if they are exposed to small amounts of intestinal contents

2. Food preparation and handling

  • Infected individuals
    • Food-borne pathogens are shed in the feces of infected persons
    • These are transferred to others through food via the fecal-oral route
    • Bacteria present in infected lesions and our nose may also be transmitted from an infected food handler to ready-to-eat foods
  • Cross-contamination-
    • Pathogens present in one food may be transferred to other foods during cooking if utensils are used without washing and disinfecting
  • Inadequate cooking temperature
  1. Food storage
    • Food held or stored at more than 250C to 600C) temperature allows multiplication of

Food poisoning and food intoxications

Epidemiological Features / Clinical Characteristics –

  • Food poisoning is an acute inflammatory disease of the gastrointestinal tract
  • It is caused by the ingestion of food contaminated with toxin-producing bacteria, their pre-formed toxins, chemical substances, or other poisonous substances
  • Food poisoning is very More than 10 million cases occur in India per year

Characteristics of Food Poisoning

  • History of ingestion of common food (as in family functions, hostels/hotels)
  • A group of persons being affected simultaneously
  • The similarity of signs and symptoms in the majority of cases
  • Common symptoms are vomiting, diarrhea, pain in the abdomen, fever, etc
  • Short incubation period
  • Absence of secondary cases
  • Laboratory tests are rarely required Types of Food Poisoning

Bacterial food poisoning

    • Caused by taking contaminated food
    • It may be:
      • Infective: Organism enters the body through the food, produce toxin, cause pathology and result in clinical manifestations (Salmonella, Clostridium perfringes, Vibrio parahaemolyticus) ‒
      • Toxic: Due to already formed toxins in the food (Staphylococcus aureus, Clostridium botulinum, Bacillus cereus

Nonbacterial food poisoning

  • Chemical poisoning: Due to pesticides, arsenic, mercury

Food Intoxications

  • Intoxications are of two categories:
    • Due to naturally occurring toxins in the food grains:
    • Lathyrism, Epidemic dropsy, Endemic ascites, Toxic polyphenol
    • Due to toxins produced by the fungi in the food grains: ‒Aflatoxicosis, Ergotism

Public health response to food-borne diseases

  1. Early detection, management, and referral
    • Identify the cases and assess for severity
    • Refer the severe cases urgently to the health center for proper management
    • Assure and help patients accordingly
    • Ensuring hydration is the mainstay of
    • Focus on assessment and reversal of dehydration, through ORS or IV fluids in serious cases
  1. Reporting of any case /outbreak and investigation
    • Inform any case/ outbreak immediately to a higher level as per the existing program /project (e.g. IDSP) guidelines
    • Outbreaks of food poisoning need to be investigated by a team and take part in such investigations (as has been discussed elsewhere in other units)
    • Investigations will help to identify appropriate control and preventive measures
  1. Health Education
    • Educating people about reservoir/source of contamination and transmission, common foods involved, signs/symptoms and danger signs, personal hygiene, and food hygiene
    • Most FBD are preventable by simple behavioral changes

Food Safety

  • Food safety describes the handling, preparation, and storage of food in ways that prevent food-borne diseases
  • The main idea is a concept of defense to prevent harm to the
  • Unsafe food poses health threats; endangering
  • It creates a vicious cycle of illness and

Food Safety Considerations and Measures

  • Policy making/administrative level – Role is of government:
    • Developing policies and regulatory frameworks (Laws, Acts, etc)
    • Establishing and implementing effective food safety systems to respond to and manage food safety risks along the entire food chain
    • Fostering collaboration among health and other sectors
  • Food handlers and consumers level:
    • Be aware of the common hazards linked with the food they use
    • Handle and prepare food safely
    • Practicing the WHO Five Keys to Safer Food at home, or when selling at restaurants or at local markets
    • Grow fruits and vegetables to decrease microbial contamination

Food Safety Regulatory Measures in India

  • FSSAI (Food Safety and Standards Authority of India)is responsible for setting standards for food by:
  • Framing of Regulations to lay down food safety standards
  • Laying down guidelines for accreditation of laboratories for food testing
  • Providing scientific advice and technical support
  • Disseminating information and promoting awareness
  • Food Safety Voice’ has been launched which helps consumers to register their complaints and feedback about food safety issues

Keep Clean

  • Wash your hands before handling food and often during food preparation
  • Wash your hands after going to the toilet
  • Wash and sanitize all surfaces and equipment used for food preparation
  • Protect kitchen areas and food from insects, pests, and other animals

Separate raw and cooked food

  • Separate raw meat, poultry, and seafood from other foods
  • Use separate utensils, knives, and cutting boards for handling raw foods
  • Store food in containers to avoid contact between raw and prepared foods

Keep food at safe temperatures

  • Do not leave cooked food at room temperature for more than 2 hours
  • Refrigerate promptly all cooked and perishable food (preferably below 5°C)
  • Keep cooked food piping hot (more than 60°C) prior to serving
  • Do not store food too long even in the refrigerator
  • Do not thaw frozen food at room temperature

Food storage, food handling, and cooking

  • General Principles of Safe Storage of Food Items
    • Chemicals and cleaning supplies are stored away from food
    • Non-vegetarian and vegetarian products are kept physically separated
    • Raw materials are kept separately with proper labeling from semi-processed and processed (cooked) foods
    • All foods are stored off the floor and away from the walls (at least 6 inches)
    • The principles of FIFO (first in first out) and FEFO (first expiry first out) should be applied

Role of Food Handlers in Food Borne Diseases

  • The term food handler includes all those involved in various stages/activities related to preparation, processing, cleaning, and chopping, making, boiling/ frying/sauté, washing of utensils, cooking and serving of food
  • Similarly, if food handlers have eye /ear/skin infection, cough, or running nose the related germs will infect the consumers
  • This spreads through their hands through eye/ ear/ skin discharges, urine, sputum
  • A cook with diseases like jaundice or typhoid may continue to spread these for a long time
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