View source for Foodborne illness

{{DiseaseDisorder infobox |
  Name           = Foodborne illness |
  Image          = |
  Caption        = |
  ICD10          = |
  ICD9           = {{ICD9|005.9}} |
  ICDO           = |
  OMIM           = |
  DiseasesDB     = 31112 |
  MedlinePlus    = |
  eMedicineSubj  = med |
  eMedicineTopic = 807 |
}}
A '''foodborne illness''' (also '''foodborne disease''') is any [[illness]] resulting from the consumption of food. Although foodborne illness is commonly called '''food poisoning''', this is often a [[misnomer]].  True food poisoning occurs when a person ingests a contaminating chemical or a natural [[toxin]], while most cases of foodborne illness are actually '''food infection''' caused by a variety of foodborne [[pathogen]]ic [[bacterium|bacteria]], [[virus]]es, [[prion]]s or [[parasite]]s.<ref>[http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm US CDC food poisoning guide]</ref>  Such contamination usually arises from improper handling, preparation, or [[food storage]]. Good [[hygiene]] practices before, during, and after food preparation can reduce the chances of contracting an illness. The action of monitoring food to ensure that it will not cause foodborne illness is known as '''[[food safety]]'''. Foodborne disease can also be caused by a large variety of toxins that affect the environment. For foodborne illness caused by chemicals, see [[Food contaminants]].

==Transmission==
Ill food handlers are one of the most common sources of foodborne illnesses. 
Some common diseases are occasionally transmitted to food through the water [[vector (biology)|vector]]. These include [[infection]]s caused by ''[[Shigella]]'', [[Hepatitis A]] and the parasites ''[[Giardia lamblia]]'' and [[Cryptosporidiosis|''Cryptosporidium parvum'']]. Contact between [[food]] and [[pest (animal)|pest]]s, especially [[fly|flies]], [[rodent]]s and [[cockroach]]es, are other food contamination vectors.

Foodborne illness can also be caused by the presence of [[pesticide]]s or [[medicine]]s in food, or by unintentionally consuming naturally toxic substances like [[mushroom poisoning|poisonous mushroom]]s or reef fish.

==Symptoms and mortality==
[[Symptom]]s typically begin several hours to several days after [[eating|ingestion]] and depending on the agent involved, can include one or more of the following: [[nausea]], [[abdominal pain]], [[vomiting]], [[diarrhea]], [[gastroenteritis]], [[pyrexia|fever]], [[headache]] or [[fatigue (physical)|fatigue]]. In most cases the body is able to permanently recover after a short period of [[Acute (medical)|acute]] discomfort and illness. However, foodborne illness can result in permanent health problems or even death, especially in [[baby|babies]], [[pregnant]] [[women]] (and their [[fetus]]es), [[elderly]] people, [[sick]] people and others with weak [[immune system]]s. Foodborne illness is a major cause of [[reactive arthritis]], which typically occurs 1–3 weeks afterward. Similarly, people with [[liver]] disease are especially susceptible to infections from [[Vibrio vulnificus]], which can be found in [[oyster]]s or crabs. Typically food poisoning is evident when uncooked, or unprepared food is eaten.

==Incubation period==

The delay between consumption of a contaminated food and appearance of the first [[symptom]]s of illness is called the [[incubation period]]. This ranges from hours to days (and rarely months or even years, such as in the case of [[Listeriosis]] or [[Creutzfeldt-Jacob disease]]), depending on the agent, and on how much was consumed. If symptoms occur within 1–6 hours after eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than live bacteria.

During the incubation period, [[microbe]]s pass through the [[stomach]] into the [[intestine]], attach to the [[cell (biology)|cell]]s lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a [[toxin]] that is absorbed into the [[blood]]stream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe. [http://www.cdc.gov/ncidod/dbmd/outbreak/guide_fd.htm]

==Infectious dose==
The infectious dose is the amount of agent that must be consumed to give rise to symptoms of foodborne illness. The infective dose varies according to the agent and consumer's age and overall health. In the case of [[Salmonella]], in healthy human volunteers, a relatively large inoculum of 1 million to 1 billion organisms is necessary to produce symptoms[http://www.emedicine.com/emerg/topic515.htm], as Salmonellae are very acid sensitive.  So, an artificially higher stomach pH level greatly reduces the number of bacteria required to cause symptoms (by 10- to a 100-fold).

==Pathogenic agents==
{{see also|Pathogen}}
An early theory on the causes of food poisoning involved [[#Ptomaine|ptomaines]], [[alkaloid]]s found in decaying animal and vegetable matter.  While some poisonous alkaloids are the cause of poisoning, the discovery of bacteria left the ptomaine theory obsolete.

===Bacteria===
[[Bacteria]] are a common cause of foodborne illness. In the [[United Kingdom]] during [[2000]] the individual bacteria involved were as follows: ''[[Campylobacter jejuni]]'' 77.3%, ''[[Salmonella]]'' 20.9%, ''[[Escherichia coli O157:H7]]'' 1.4%, and all others less than 0.1% [http://www.food.gov.uk/science/sciencetopics/microbiology/58736].  In the past, bacterial infections were thought to be more prevalent because few places had the capability to test for norovirus and no active surveillance was being done for this particular organism.  Symptoms for bacterial infections are delayed because the bacteria need time to multiply. They are usually not seen until 12–72 [[hour]]s or more after eating contaminated food.

Common bacterial foodborne pathogens are:
*''[[Bacillus cereus]]''
*''[[Campylobacter|Campylobacter jejuni]]'' which can lead to secondary [[Guillain-Barré syndrome]]
<!-- Unsourced image removed: [[Image:Listeria.jpg|right|thumb|200px|''[[Listeria monocytogenes]]'']] -->
*''[[Escherichia coli O157:H7]]'' enterohemorrhagic (EHEC) which causes [[hemolytic-uremic syndrome]]
*[[Escherichia coli - enteroinvasive]] (EIEC)
*[[Escherichia coli - enteropathogenic]] (EPEC)
*[[Escherichia coli - enterotoxigenic]] (ETEC)
*[[Escherichia coli - enteroaggregative]] (EAEC or EAgEC)
[[Image:SalmonellaNIAID.jpg|right|200px|thumb|''Salmonella'']]
*''[[Listeria monocytogenes]]''
*''[[Salmonella]]'' spp. - its ''S. Typhimurium'' infection is caused by consumption of eggs that are not adequately cooked or by other interactive human-animal pathogens <ref name=aoostpt>{{cite web
| last = Tribe 
| first = Ingrid G. ''et al.'' 
| authorlink = 
| coauthors = 
| title = An outbreak of Salmonella Typhimurium phage type 135 infection linked to the consumption of raw shell eggs in an aged care facility <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/cda-pubs-cdi-2002-cdi2601-cdi2601h.htm}}</ref><sup>,</sup> <ref name=sisaa>{{cite web
| last = Centers for Disease Control and Prevention 
| first = 
| authorlink = 
| coauthors = 
| title = Salmonella Infection (salmonellosis) and Animals <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.cdc.gov/healthypets/diseases/salmonellosis.htm}}</ref><sup>,</sup> <ref name=rcfp>{{cite web
| last = Doyle
| first = M. P.
| authorlink = 
| coauthors = M. C. Erickson
| title = Reducing the carriage of foodborne pathogens in livestock and poultry <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.poultryscience.org/ps/paperpdfs/06/p0660960.pdf}}</ref>.
*''[[Shigella]]'' spp.
*''[[Streptococcus]]''
*''[[Vibrio cholerae]]'', including  O1 and non-O1
*''[[Vibrio parahaemolyticus]]''
*''[[Vibrio vulnificus]]''
*''[[Yersinia enterocolitica]]'' and ''[[Yersinia pseudotuberculosis]]''

Less common bacterial agents:
*''[[Brucella]]'' spp.
*''[[Actinobacteria|Corynebacterium ulcerans]]''
*''[[Q fever|Coxiella burnetii]]'' or Q fever
*''[[Plesiomonas shigelloides]]''

====Exotoxins====
In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by [[exotoxin]]s which are [[excretion|excreted]] by the cell as the bacterium grows. Exotoxins can produce illness even when the microbes that produced them have been killed. Symptoms typically appear after 1–6 hours depending on the amount of toxin ingested.

*''[[Clostridium botulinum]]''
*''[[Clostridium perfringens]]''
*''[[Staphylococcus aureus]]''
*''[[Bacillus cereus]]''

For example ''[[Staphylococcus aureus]]'' produces a toxin that causes intense [[vomiting]]. The rare but potentially deadly disease [[botulism]] occurs when the [[Anaerobic organism|anaerobic]] bacterium ''[[Clostridium botulinum]]'' grows in improperly canned low-acid foods and produces [[botulin]], a powerful paralytic toxin.

=== Mycotoxins & alimentary mycotoxicoses ===
The term '''alimentary mycotoxicoses''' refers to the effect of poisoning by [[Mycotoxins]] through food consumption.  [[Mycotoxins]] have prominently affected on human and animal health in such ways that an outbreak occurred in the UK in 1960 caused the death of 100,000 turkeys which had consumed [[aflatoxin]]-contaminated peanut meal and the death of 5000 human life by [[Alimentary toxic aleukia]] (ALA) in the [[USSR]] in [[World War II]] is a well known case of mycotoxicoses <ref name=fam>{{cite web
| last = E. Mount 
| first = Michael 
| authorlink = 
| coauthors = 
| title = Fungi and Mycotoxins <internet>
| publisher = 
| accessdate = 11 August
| accessyear = 2007
| url = http://www.vetmed.ucdavis.edu/PHR/PHR250/2007/25007Myc.pdf}}</ref>.  The common foodborne [[Mycotoxins]] include

* [[Aflatoxins]] - originated from [[Aspergillus parasiticus]] and [[Aspergillus flavus]].  They are frequently found in tree nuts, peanuts, maize, sorghum and other oilseeds, including corn and cottonseeds.  The pronounced forms of [[Aflatoxins]] are those of B1, B2, G1, and G2, amongst which Aflatoxin B1 usually predominantly target living being's liver, which will result in [[necrosis]], [[cirrhosis]], and [[carcinoma]] <ref name=afltx>{{cite web
| last = Center for Food Safety & Applied Nutrition
| first = 
| authorlink = 
| coauthors = 
| title = Aflatoxins <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.cfsan.fda.gov/~mow/chap41.html}}</ref><sup>,</sup> <ref name=gtlmg>{{cite web
| last = Food and Agriculture Organization of the United Nations
| first = 
| authorlink = 
| coauthors = 
| title = GASGA Technical Leaflet - 3 Mycotoxins in Grain <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.fao.org/Wairdocs/X5008E/X5008e01.htm}}</ref>. In the US, the acceptable level of total aflatoxins in foods has to be less than 20 &mu;g/Kg, among which Aflatoxin M1 in milk should be less than 0.5 &mu;g/Kg <ref name=cfh>{{cite web
| last = World Health Organization
| first = 
| authorlink = 
| coauthors = 
| title = Chapter 2 Foodborne Hazards in ''Basic Food Safety for Health Workers'' <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.who.int/entity/foodsafety/publications/capacity/en/2.pdf}}</ref>.  The official document can be found at [[Food and Drug Administration|FDA]]'s website <ref name=sec683100>{{cite web
| last = Food and Drug Administration
| first = 
| authorlink = 
| coauthors = 
| title = Sec. 683.100 Action Levels for Aflatoxins in Animal Feeds (CPG 7126.33) <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.fda.gov/ora/compliance_ref/cpg/cpgvet/cpg683-100.html}}</ref><sup>,</sup> <ref name=mfcvmp>{{cite web
| last = Henry
| first = Michael H. 
| authorlink = 
| coauthors = 
| title = Mycotoxins in Feeds:  CVM’s Perspective <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.fda.gov/cvm/fdaaustintx823.htm}}</ref>.

* [[Altertoxins]] - are those of [[Alternariol]] (AOH), [[Alternariol methyl ether]] (AME), [[Altenuene]] (ALT), [[Altertoxin-1]] (ATX-1), [[Tenuazonic acid]] (TeA) and [[Radicinin]] (RAD), originated from [[Alternaria]] spp.  Some of the toxins can be present in sorghum, [[Finger millet|ragi]], wheat and tomatoes <ref name=atwdw>{{cite web
| last =  Webley
| first =  D. J. ''et al.''
| authorlink = 
| coauthors = 
| title = Alternaria toxins in weather-damaged wheat and sorghum in the 1995-1996 Australian harvest <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.publish.csiro.au/paper/A97005.htm}}</ref><sup>,</sup> <ref name=amwwc>{{cite web
| last =  Li
| first =  Feng-qin
| authorlink = 
| coauthors = Takumi Yoshizawa
| title = Alternaria Mycotoxins in Weathered Wheat from China <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://pubs.acs.org/cgi-bin/abstract.cgi/jafcau/2000/48/i07/abs/jf0000171.html}}</ref><sup>,</sup> <ref name=sbtp>{{cite web
| last =  da Motta
| first =  Silvana
| authorlink = 
| coauthors = Lucia M. Valente Soares
| title = Survey of Brazilian tomato products for alternariol, alternariol monomethyl ether, tenuazonic acid and cyclopiazonic acid <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.informaworld.com/smpp/content~content=a713810863~db=all}}</ref>.  A few researches have showed that the toxins can be easily cross-contaminated between grain commodities, suggesting that manufacturing and storage of grain commodities is a critical practice <ref name=pamaa>{{cite web
| last =  Li
| first =  F. Q. ''et al.''
| authorlink = 
| coauthors = 
| title =  Production of Alternaria Mycotoxins by Alternaria alternata Isolated from Weather-Damaged Wheat <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.ingentaconnect.com/content/iafp/jfp/2001/00000064/00000004/art00025}}</ref>.

* [[Citrinin]] - 

* [[Citreoviridin]] -

* [[Cyclopiazonic acid]] -

* [[Cytochalasins]]

* [[Ergot alkaloids]] / [[Ergopeptine]] [[alkaloids]] - [[Ergotamine]]

* [[Fumonisins]] - Crop corn can be easily contaminated by the fungi [[Fusarium moniliforme]], and its [[Fumonisin B1]] will cause [[Leukoencephalomalacia]] (LEM) in horses, [[Pulmonary edema syndrome]] (PES) in pigs, liver cancer in rats and [[Esophageal cancer]] in humans <ref name=ftihah>{{cite web
| last = Marasas
| first = Walter F. O.
| authorlink = 
| coauthors = 
| title = Fumonisins: Their implications for human and animal health <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www3.interscience.wiley.com/cgi-bin/abstract/112640083/ABSTRACT?CRETRY=1&SRETRY=0}}</ref><sup>,</sup> <ref name=off>{{cite web
| last = Soriano
| first = J.M.
| authorlink = 
| coauthors = S. Dragacci
| title = Occurrence of fumonisins in foods <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T6V-4D636PW-1&_user=10&_coverDate=01%2F01%2F2004&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4a033a232e75e4ebf3ee269c06744491}}</ref>.  For human and animal health, Both [[Food and Drug Administration|FDA]] and [[European commission|EC]] have regulated the content levels of the toxins in food and animal feeds <ref name=CVMF>{{cite web
| last = Food and Drug Administration
| first = 
| authorlink = 
| coauthors = 
| title = CVM and Fumonisins <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.fda.gov/cvm/fumonisin.htm}}</ref><sup>,</sup> <ref name=mcmmp>{{cite web
| last = Food Standards Agency
| first = 
| authorlink = 
| coauthors = 
| title = More contaminated maize meal products withdrawn from sale <internet>
| publisher = 
| accessdate = 12 August
| accessyear = 2007
| url = http://www.food.gov.uk/news/newsarchive/2003/sep/moremaize}}</ref>.

* [[Fusaric acid]] - 

* [[Fusarochromanone]] - 

* [[Kojic acid]] - ?

* [[Lolitrem alkaloids]] -

* [[Moniliformin]] - 

* [[3-Nitropropionic acid]] -

* [[Nivalenol]] -

* [[Ochratoxins]] - In Australia, The Limit of Reporting (LOR) level for [[Ochratoxin A]] (OTA) analyses in 20th Australian Total Diet Survey was 1 µg/kg <ref name=2atds>{{cite web
| last = Food Standards Australia New Zealand
| first = 
| authorlink = 
| coauthors = 
| title =  20th Australian Total Diet Survey - Part B <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.foodstandards.gov.au/newsroom/publications/20thaustraliantotaldietsurveyjanuary2003/20thaustraliantotaldietsurveyfullreport/partb20thatds/partbmetals.cfm}}</ref>, whereas [[European commission|EC]] restricts the content of OTA to 5 µg/kg in cereal commodities, 3 µg/kg in the processed products and 10 µg/kg in dried vine fruits <ref name=wrmff>{{cite web
| last = FAO FOOD AND NUTRITION PAPER 81
| first = 
| authorlink = 
| coauthors = 
| title =  Worldwide regulations for mycotoxins in food and feed in 2003 <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.fao.org/docrep/007/y5499e/y5499e0f.htm}}</ref>. 

* [[Oosporeine]] -

* [[Patulin]] - Currently, this toxin has been advisably regulated on fruit products.  [[European Commission|EC]] and [[Food and Drug Administration|FDA]] have tightened it within 50 µg/kg for fruit juice and fruit nectar, while the limits of 25 µg/kg for solid-contained fruit products and 10 µg/kg for baby foods were specified by [[European Commission|EC]] <ref name=wrmff>{{cite web
| last = FAO FOOD AND NUTRITION PAPER 81
| first = 
| authorlink = 
| coauthors = 
| title =  Worldwide regulations for mycotoxins in food and feed in 2003 <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.fao.org/docrep/007/y5499e/y5499e0f.htm}}</ref><sup>,</sup> <ref name=pajajc>{{cite web
| last = Food and Drug Administration
| first = 
| authorlink = 
| coauthors = 
| title =  Patulin in Apple Juice, Apple Juice Concentrates and Apple Juice Products <internet>
| publisher = 
| accessdate = 16 August
| accessyear = 2007
| url = http://vm.cfsan.fda.gov/~dms/patubckg.html}}</ref>

* [[Phomopsins]] -

* [[Sporidesmin A]] -

* [[Sterigmatocystin]] -

* [[Tremorgenic]] [[mycotoxins]] - Five of them have been reported to be associated with molds found in fermented meats.  These are [[Fumitremorgen B]], [[Paxilline]], [[Penitrem A]], [[Verrucosidin]], and [[Verruculogen]] <ref name=gaftm>{{cite web
| last = Sabater-Vilar
| first = M.
| authorlink = 
| coauthors = 
| title =   Genotoxicity Assessment of Five Tremorgenic Mycotoxins (Fumitremorgen B, Paxilline, Penitrem A, Verruculogen, and Verrucosidin) Produced by Molds Isolated from Fermented Meats <internet>
| publisher = 
| accessdate = 16 August
| accessyear = 2007
| url = http://www.ingentaconnect.com/content/iafp/jfp/2003/00000066/00000011/art00023}}</ref>.

* [[Trichothecenes]] - sourced from [[Cephalosporium]], [[Fusarium]], [[Myrothecium]], [[Stachybotrys]] and [[Trichoderma]].  The toxins are usually found in molded maize, wheat, corn, peanuts and rice, or animal feed of hay and straw <ref name=ofst>{{cite web
| last = Adejumo 
| first = Timothy O.
| authorlink = 
| coauthors = 
| title = Occurrence of Fusarium species and trichothecenes in Nigerian maize <internet>
| publisher =  Elsevier
| accessdate = 12 August
| accessyear = 2007
| url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4N5CX4H-3&_user=10&_coverDate=05%2F30%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d02d1b28456dfbef669d57692ac28244}}</ref><sup>,</sup> <ref name=snhe>{{cite web
| last = Mazur 
| first = Lynnette J. 
| authorlink = 
| coauthors = Janice Kim
| title = Spectrum of Noninfectious Health Effects From Molds <internet>
| publisher =  American Academy of Pediatrics 
| accessdate = 12 August
| accessyear = 2007
| url = http://pediatrics.aappublications.org/cgi/content/full/118/6/e1909}}</ref>.  Four trichothecenes, T-2 toxin, HT-2 toxin, [[diacetoxyscirpenol]] (DAS) and [[deoxynivalenol]] (DON) have been most prominently encountered by humans and animals.  The consequences of oral intake of, or dermal exposure to, the toxins will result in the illness of [[Alimentary toxic aleukia]], [[neutropenia]], [[aplastic anemia]], [[thrombocytopenia]] and skin irritaion <ref name=tthm>{{cite web
| last = Froquet 
| first = R. ''et al.''
| authorlink = 
| coauthors = 
| title = Trichothecene toxicity on human megakaryocyte progenitors (CFU-MK) <internet>
| publisher =  SAGE Publications 
| accessdate = 12 August
| accessyear = 2007
| url = http://het.sagepub.com/cgi/content/abstract/20/2/84}}</ref><sup>,</sup> <ref name=csytt>{{cite web
| last = Joffe 
| first = A. Z.
| authorlink = 
| coauthors = B. Yagen
| title = Comparative study of the yield of T-2 toxic produced by Fusarium poae, F. sporotrichioides and F. sporotrichioides var. tricinctum strains from different sources <internet>
| publisher =  SAGE Publications 
| accessdate = 12 August
| accessyear = 2007
| url = http://het.sagepub.com/cgi/content/abstract/20/2/84}}</ref><sup>,</sup> <ref name=fis>{{cite web
| last =  Hay
| first =  Rod J.
| authorlink = 
| coauthors = B. Yagen
| title = Fusarium infections of the skin <internet>
| publisher =  
| accessdate = 12 August
| accessyear = 2007
| url = http://www.co-infectiousdiseases.com/pt/re/coinfdis/abstract.00001432-200704000-00002.htm;jsessionid=G2JGL27MSRdb4TS82LyckCgxLH2zJLX3ynBfjz5kjMyfh4WpVkLg!1152499061!181195629!8091!-1}}</ref>.  In 1993, [[Food and Drug Administration|FDA]] issued a document for the content limits of DON in food and animal feeds at an advisory level <ref name=gifda>{{cite web
| last = Food and Drug Administration
| first = 
| authorlink = 
| coauthors = 
| title = Guidance for Industry and FDA - Letter to State Agricultural Directors, State Feed Control Officials, and Food, Feed, and Grain Trade Organizations <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.cfsan.fda.gov/~dms/graingui.html}}</ref>. In 2003, US published a patent that is very promising for farmers to produce a trichothecene-resistant crop <ref name=trtp>{{cite web
| last = Hohn
| first = Thomas M.
| authorlink = 
| coauthors = 
| title =  Trichothecene-resistant transgenic plants <internet>
| publisher = 
| accessdate = 13 August
| accessyear = 2007
| url = http://www.patentstorm.us/patents/6646184.html}}</ref>.

* [[Zearalenone]] -

* [[Zearalenols]] -


====Emerging foodborne pathogens====
Much is still not known about foodborne illness.  Approximately sixty percent of outbreaks are still caused by unknown sources.   

*''[[Aeromonas hydrophila]]'', ''Aeromonas caviae'', ''Aeromonas sobria''

====Preventing bacterial food poisoning====
The prevention is mainly the role of the state, through the definition of strict rules of [[hygiene]] and a [[public services|public service]] of [[veterinary medicine|veterinary]] survey of the food chain, from [[farming]] to the transformation industry and the delivery (shops and [[restaurant]]s). This regulation includes:
* [[traceability]]: in a final product, it must be possible to know the origin of the ingredients (originating farm, identification of the harvesting or of the animal) and where and when it was processed; the origin of the illness can thus be tracked and solved (and possibly penalized), and the final products can be removed from the sale if a problem is detected;
* respect of hygiene procedures like [[HACCP]] and the "[[cold chain]]";
* power of control and of law enforcement of the [[veterinarian]]s.
At home, the prevention mainly consists of good [[food safety]] practices.

In August 2006, the United States [[Food and Drug Administration]] approved [[Phage therapy]] which involves spraying meat with viruses that infect bacteria, and thus prevents infection with [[bacteria]]. This has raised concerns since without [[mandatory labelling]] consumers won't be aware that meat and poultry products have been treated with the spray. [http://www.forbes.com/business/healthcare/feeds/ap/2006/08/18/ap2959720.html]

===Viruses===
[[Virus|Viral]] infections make up perhaps one third of cases of food poisoning in developed countries.  In the US, more than 50% of cases are viral and [[Norwalk virus group|noroviruses]] are the most common foodborne illness, causing 57% of outbreaks in 2004.  Foodborne viral infection are usually of intermediate (1–3 days) [[incubation period]], causing illnesses which are self-limited in otherwise healthy individuals, and are similar to the bacterial forms described above.
[[Image:Rotavirus.jpg|right|200px|thumb|Rotavirus]]
* [[Enterovirus]]
* [[Hepatitis A]] is distinguished from other viral causes by its prolonged (2–6 week) [[incubation period]] and its ability to spread beyond the stomach and intestines, into the [[liver]].  It often induces [[jaundice]], or yellowing of the skin, and rarely leads to chronic liver dysfunction.  The virus has been found to cause the infection due to the consumption of fresh-cut produce which has fecal contamination <ref name=ivcma>{{cite web
| last = Dubois 
| first = Eric ''et al.''  
| authorlink = 
| coauthors = 
| title = Intra-laboratory validation of a concentration method adapted for the enumeration of infectious F-specific RNA coliphage, enterovirus, and hepatitis A virus from inoculated leaves of salad vegetables <internet>
| publisher = 
| accessdate = 11 August
| accessyear = 2007
| url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4HYMVXK-4&_user=10&_coverDate=04%2F25%2F2006&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=29d010eafc89179a9a66fd24a4b44e21}}</ref><sup>,</sup> <ref name=imqsf>{{cite web
| last = Schmidt 
| first = Heather Martin  
| authorlink = 
| coauthors = 
| title = Improving the microbilological quality and safety of fresh-cut tomatoes by low dose dlectron beam irradiation - Master thesis <internet>
| publisher = 
| accessdate = 11 August
| accessyear = 2007
| url = http://txspace.tamu.edu/bitstream/1969.1/2767/1/etd-tamu-2004B-FSTC-Schmidt.pdf}}</ref>.  
* [[Hepatitis E]]
* [[Norovirus]]
* [[Rotavirus]]

===Parasites===
Most foodborne [[parasite]]s are [[zoonosis|zoonoses]].

[[Platyhelminthes]]:
* ''[[Diphyllobothrium]]'' sp.
[[Image:Tenia solium scolex.jpg|right|200px|thumb|The scolex of ''Tenia solium'']]
*''[[Nanophyetus]]'' sp.
*''[[Taenia saginata]]''
*''[[Taenia solium]]''
*''[[Fasciola hepatica]]''
''See also: [[Tapeworm]] and [[Flatworm]]''

[[Nematode]]:
*''[[Anisakis]]'' sp.
*''[[Ascaris lumbricoides]]''
*''[[Eustrongylides]]'' sp.
*''[[Trichinosis|Trichinella spiralis]]''
*''[[Trichuris trichiura]]''

[[Protozoa]]:
[[Image:Giardia lamblia.jpg|right|200px|thumb|''Giardia lamblia'']]
* ''[[Acanthamoeba]]'' and other free-living [[amoeba]]e
* ''[[Cryptosporidiosis|Cryptosporidium parvum]]''
* ''[[Cyclospora cayetanensis]]''
* ''[[Entamoeba histolytica]]''
* ''[[Giardia lamblia]]''
* ''[[Sarcocystis hominis]]''
* ''[[Sarcocystis suihominis]]''
* ''[[Toxoplasma gondii]]''

===Natural toxins===
In contrast several foods can naturally contain [[toxins]] that are not produced by bacteria and occur naturally in foods, these include:
* [[Alkaloid]]s
* [[Ciguatera poisoning]]
* [[Grayanotoxin]] ([[honey]] intoxication)
* [[Mushroom poisoning|Mushroom]] toxins
* [[Phytohaemagglutinin]] (Red [[kidney bean]] poisoning)
* [[Pyrrolizidine alkaloid]]
* [[Shellfish toxin]], including [[Paralytic shellfish poisoning]], Diarrhetic shellfish poisoning, Neurotoxic shellfish poisoning, [[domoic acid|Amnesic shellfish poisoning]] and Ciguatera fish poisoning
* [[Scombrotoxin]]
* [[Tetrodotoxin]] ([[Pufferfish|Fugu fish]] poisoning)

===Other pathogenic agents===
* [[Prion]]s, resulting in [[Creutzfeldt-Jakob disease]]

==Global Impact==

In modern times, rapid globalization of food production and trade has increased the potential likelihood of food contamination. Many outbreaks of foodborne diseases that were once contained within a small community may now take place on global dimensions. [[Food safety]] authorities all over the world have acknowledged that ensuring food safety must not only be tackled at the national level but also through closer linkages among food safety authorities at the international level. This is important for exchanging routine information on food safety issues and to have rapid access to information in case of food safety emergencies."

It is difficult to estimate the global incidence of foodbourne disease, but it has been reported that in the year 2000 about 2.1 million people died from diarrhoeal diseases. Many of these cases have been attributed to contamination of food and drinking water. Additionally, diarrhoea is a major cause of malnutrition in infants and young children. 

Even in industrialized countries, up to 30% of the population of people have been reported to suffer from foodborne diseases every year. In the U.S, around 76 million cases of foodborne diseases, which resulted in 325,000 hospitalizations and 5,000 deaths, are estimated to occur each year.  Developing countries in particular, are worst affected by foodborne illnesses due to the presence of a wide range of dieases, including those caused by parasites. Foodborne illnesses can and did inflict serious and extensive harm on society.  In 1994, an outbreak of salmonellosis due to contaminated ice cream occurred in the USA, affecting an estimated 224,000 persons. In 1988, an outbreak of hepatitis A, resulting from the consumption of contaminated clams, affected some 300,000 individuals in China.

Food contamination creates an enormous social and economic strain on societies.  In the U.S., diseases caused by the major pathogens alone are estimated to cost up to US $35 billion annually (1997) in medical costs and lost productivity. The re-emergence of cholera in Peru in 1991 resulted in the loss of US $500 million in fish and fishery product exports that year.

==Statistics==
Every year there are about 76 million foodborne illnesses in the [[United States]] (26,000 cases for 100,000 inhabitants), 2 million in the [[United Kingdom]] (3,400 cases for 100,000 inhabitants) and 750,000 in [[France]] (1,210 cases for 100,000 inhabitants).

===United States===
In the United States, there are approximately 76 million foodborne illnesses (26,000 cases for 100,000 inhabitants):<ref>{{cite web 
 | url=http://www.who.int/mediacentre/factsheets/fs237/en/ 
 | title=Food safety and foodborne illness
 | pulisher=WHO}}</ref>
* 325,000 were hospitalized (111 per 100,000 inhabitants);
* 5,000 people [[death|died]] (1.7 per 100,000 inhabitants.).
* Major pathogens from food borne illness in the United States cost upwards of US $35 billion dollars in medical costs and lost productivity (1997)

===France===
In France, for 750,000 cases (1,210 per 100,000 inhabitants):
* 70,000 people consulted in the emergency department of an hospital (113 per 100,000 inhab.);
* 113,000 people were hospitalized (24 per 100,000 inhabitants);
* 400 people died (0.9 per 100,000 inhabitants).

===Australia===
In Australia, there are an estimated 5.4 million cases of food-borne illness every year, causing:<ref>{{cite web 
 | url=http://www.ozfoodnet.org.au/internet/ozfoodnet/publishing.nsf/Content/reports-1/$FILE/foodborne_report.pdf 
 | title=Food borne illness in Australia
 | pulisher=OzFoodNet}}</ref>
* 18,000 hospitalisations
* 120 deaths
* 2.1 million lost days off work
* 1.2 million doctor consultations
* 300,000 prescriptions for antibiotics

{{Col-begin}}
{{Col-2}}
{|class="wikitable" style="font-size:95%"
|+ Causes of foodborne illness in [[France]]<ref>{{cite web 
 | url=http://www.invs.sante.fr/publications/2004/inf_origine_alimentaire/inf_origine_alimentaire.pdf
 | title=Report of the French sanitary agencies
 | publisher=INVS/Afssa
 | language=French}}
</ref>
<ref>{{cite web 
 | url=http://www.invs.sante.fr/publications/2004/inf_origine_alimentaire/grilleLecture.pdf 
 | title=Summary of Report of the French sanitary agencies
 | publisher=INVS/Afssa
 | language=French}}
</ref>
|-
! !! Cause !! Annual cases !! Rate<br /><small>(per 100,000 inhabitants)</small>
|-
| 1 || ''[[Salmonella]]'' || ~8,000 cases || align="center"|13
|-
| 2 || ''[[Campylobacter]]'' || ~3,000 cases || align="center"|4.8
|-
| 3 || [[Parasite]]s<br />incl. [[Toxoplasma]] || ~500 cases<br />~400 cases || align="center"|0.8<br />0.65
|-
| 4 || ''[[Listeria]]'' || ~300 cases || align="center"|0.5
|-
| 5 || [[Hepatitis A]] || ~60 cases || align="center"|0.1
|}
{{Col-2}}
{|class="wikitable" style="font-size:95%;"
|+ Causes of death by foodborne illness in [[France]]
|-
! !! Cause !! Annual !! Rate<br><small>(per 100,000 inhabitants)</small>
|-
| 1 || ''[[Salmonella]]'' || ~300 cases || align="center"|0.5
|-
| 2 || ''[[Listeria]]'' || ~80 cases || align="center"|0.13
|-
| 3 || [[Parasite]]s || ~37 cases || align="center"|0.06<br />(95% due to [[toxoplasma]])
|-
| 4 || ''[[Campylobacter]]'' || ~15 cases || align="center"|0.02
|-
| 5 || [[Hepatitis A]] || ~2 cases || align="center"|0.003
|}
{{Col-end}}

==Outbreaks==
The vast majority of reported cases of foodborne illness occur as individual or [[sporadic]] cases. The origin of most [[sporadic]] cases is undetermined.  In the United States, where people eat outside the home frequently, most outbreaks (58%) originate from commercial food facilities (2004 FoodNet data).   An outbreak is defined as occurring when two or more people experience similar illness after consuming food from a common source.  

Often, a combination of events contributes to an outbreak, for example, food might be left at room temperature for many hours, allowing bacteria to [[multiplication|multiply]] which is compounded by inadequate cooking which results in a failure to kill the dangerously elevated bacterial levels.

Outbreaks are usually identified when those affected know each other. However, more and more, outbreaks are identified by [[public health]] staff from unexpected increases in laboratory results for certain strains of bacteria.  Outbreak detection and investigation in the United States is primarily handled by local health jurisdictions and is inconsistent from district to district.  It is estimated that 1–2 % of outbreaks are detected.

==Ptomaine==
"Ptomaine" is a former name for a supposed group of chemical substances that were theorized to cause food poisoning. The word "ptomaine" is no longer used scientifically.

==Political issues==
===United Kingdom===
Since the 1970's, key changes in UK [[food safety]] law have taken place following serious outbreaks of foodborne illness. These included the death of 19 patients in the Stanley Royd Hospital outbreak [http://briandeer.com/social/stanley-royd.htm]; and the death of 17 people in the [[1996]] Wishaw outbreak of E.coli O157 [http://www.scotland.gov.uk/deleted/library/documents-w4/pgr-00.htm], which was a precursor to the establishment of the [[Food Standards Agency]] which, according to [[Tony Blair]] in the [[1998]] [[white paper]]  [http://www.archive.official-documents.co.uk/document/maffdh/fsa/fsa.htm ''A Force for Change'' Cm 3830] "would be powerful, open and dedicated to the interests of consumers".

===United States===
In 2001, the [http://www.cspinet.org/ Center for Science in the Public Interest (CSPI)] petitioned the [[United States Department of Agriculture]] to require meat packers to remove [[spinal cord]]s before processing cattle carcasses for human consumption, a measure designed to lessen the risk of infection by variant [[Creutzfeldt-Jakob disease]]. The petition was supported by the [[American Public Health Association]], the [[Consumer Federation of America]], the [[Government Accountability Project]], the [[National Consumers League]], and Safe Tables Our Priority. This was opposed by the [[National Cattlemen's Beef Association]], the National Renderers Association, the [[National Meat Association]], the Pork Producers Council, sheep raisers, milk producers, the Turkey Federation, and eight other organizations from the animal-derived food industry. This was part of a larger controversy regarding the United States' violation of [[World Health Organization]] proscriptions to lessen the risk of infection by variant Creutzfeldt-Jakob disease.

==Organizations==

'''World Health Organization Food Safety Department'''
The WHO provides scientific advice for organizations and the public on issues concerning the safety of food. It serves as a medium linking the [[food safety]] systems in countries around the world. Food safety is currently one of WHO's top ten priorities.Food Safety is one of the major issues in our world today, and the Organization calls for more systematic and aggressive steps to be taken to significantly reduce the risk of foodborne diseases.  

'''The Department of Food Safety, Zoonoses and Foodborne Diseases''' 
The Department of Food Safety, Zoonoses and Foodborne Diseases is a department under the WHO.  Its mission is to: to reduce the serious negative impact of foodborne diseases worldwide.  According to the WHO website, food and waterborne diarrhoeal diseases are leading causes of illness and death in less developed countries, killing approximately 1.8 million people annually, most of whom are children
"WHO works closely with the Food and Agriculture Organization of the United Nations (FAO) to address food safety issues along the entire food production chain--from production to consumption--using new methods of risk analysis. These methods provide efficient, science-based tools to improve food safety, thereby benefiting both public health and economic development."

'''The International Food Safety Authorities Network (INFOSAN)'''
This Network is is intended to complement and support the existing WHO Global Outbreak Alert and Response Network (GOARN) which includes a Chemical Alert and Response component.

== Academic resources ==

=== Periodicals ===
* [http://www.sciencedirect.com/science/journal/01681605 International Journal of Food Microbiology], ISSN: 0168-1605, Elsevier
* Mycopathologia, ISSN: [http://www.springerlink.com/content/102966/ 1573-0832] (electronic) 0301-486X (paper), Springer

=== Books ===
* Advances in Food Mycology (Advances in Experimental Medicine and Biology) (2006) by A.D. Hocking ''et al.'', ISBN-13: 978-0387283913 (electronic) 978-0387283852 (paper), Springer
* Foodborne Infections and Intoxications (2006) by Hans P. Riemann and Dean O. Cliver, ISBN 012588365X, Elsevier
* Foodborne Pathogens: Microbiology And Molecular Biology (2005) by Pina M. Fratamico ''et al.'', ISBN-10: 190445500X ISBN-13: 978-1904455004, Caister Academic Press

==See also==
{{col-begin}}
{{col-3}}
* [[2006 North American E. coli outbreak]]
* [[Alexander Litvinenko poisoning]]
* [[Attack rate]]
* [[Centers for Disease Control and Prevention|United States Disease Control and Prevention]]
* [[Food Testing Strips]]
* [[Food quality]]
* [[Food safety]]
{{col-3}}
* [[Gastroenteritis]]
* [[ISO 16050]]
* [[Juice]]
* [[List of infectious diseases]]
* [[List of poisonings]]
* [[List of foodborne illness outbreaks]]
{{col-3}}
* [[Mycotoxicology]]
* [[Minamata disease]]
* [[Munir Said Thalib]]
* [[Risk assessment]]
{{col-end}}

== Notes ==
<div class="references-small"><references/></div>

==External links==
* [http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5510a1.htm Surveillance for Foodborne-Disease Outbreaks --- United States, 1998--2002]
* [http://azarticles.com/Categories/Food_and_Drink/Preventing_Food_Poisoning.php Preventing Food Poisoning]
*[http://www.veriprime.org VeriPrime Food Safety Alliance New Farm to Fork Food Safety System]
*[http://www.foodsqm.com Food Safety News FoodSQM.com]
* [http://www.who.int/mediacentre/factsheets/fs124/en/ Foodborne diseases, emerging], [[WHO]], Fact sheet N°124, revised January [[2002]]
* [http://www.foodauthority.nsw.gov.au/fb-foodborne-illness.htm Foodborne illness information pages], NSW Food Authority
* [http://www.who.int/mediacentre/factsheets/fs237/en/ Food safety and foodborne illness], [[WHO]], Fact sheet N°237, revised January [[2002]]
*[http://www.hpa.org.uk/infections/ UK Health protection Agency]
*[http://www.cdc.gov/pulsenet/ US PulseNet]
*[http://science.ntu.ac.uk/external/Foodborne%20illness.html Nottingham Trent University Foodborne illness research data]
*[[Safe Tables Our Priority (S.T.O.P.)]]
*[http://www.foodlink.org.uk/factfile.asp?file=1 Food and Drink Federation Guide]
*[http://www.netdoctor.co.uk/health_advice/facts/salmonella.htm Salmonella food poisoning]
*[http://aggie-horticulture.tamu.edu/extension/poison.html Bacterial Food Poisoning]
*[http://www.bbc.co.uk/health/conditions/foodpoisoning1.shtml BBC Information]
*[http://www.nlm.nih.gov/medlineplus/ency/article/001652.htm Medline]
*[http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=411 UK NHS Information]
*[http://www.foodsafetynetwork.ca/en/ Food Safety Network] 
*[http://dmoz.org/Health/Conditions_and_Diseases/Food_and_Water_Borne/ Open Directory Food and Water Borne Diseases Category]
*[http://www.arrowscientific.com.au/educational-material/food-poisoning.html Food poisoning basics]
*[http://www.who.int/ The World Health Organization]
*[http://www.fda.gov/ The United States FDA]
*[http://www.food.gov.uk/ Food Standard Agency website] 
*[http://active.inspection.gc.ca/eng/util/newrsse.asp?cid=44&scid= The Canadian Food Inspection Agency Website]
* Genome information for some of the organisms causing foodborne illness (diarrheagenic ''E. coli'' and ''Salmonella'') is available from the [http://www.ericbrc.org NIAID Enteropathogen Resource Integration Center (ERIC)]




{{CDC}}

[[Category:Food safety]]
[[Category:Foodborne illnesses|*]]
[[Category:Infectious diseases]]
[[Category:Nutrition]]