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
- 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
- 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
- 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
- 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
- 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
