DISEASES TIUNSMITTEDBY FOODS

( A CLASSIFICATION AND SUMMARY)

SECOND EDITION

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPUBLIC HEALTH SERVICE

CENTERS FOR DISEASE CONTROLCENTER FOR PROFESSIONAL DEVELOPMENT AND TRAINING

ATLANTA. GEORGIA 30333

DISEASES TIUNSMITTEDBY FOODS

( A CIJiSSIFICATION AND SUMMARY)

SECOND EDITION

Frank L. Bryan, Ph.D., M.P.H.—

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPUBLIC HEALTH SERVICE

CENTERS FOR DISEASE CONTROLCENTER FOR PROFESSIONAL DEVE~PMENR AN_QTRAtNING

ATLANTA, GEORGIA 30333

1982

DISEASES TRANSMITTED BY FOODS

CONTENTS

Page

INTRODUCTION

BACTERIAL DISEASESDiseases of Contemporary ImportanceUsually Transmitted by Other Means but Sometimes FoodborneDiseases in Which Proof of Transmission by FoodsIs Inconclusive

Unknown Role in Foodborne Transmission (PathogenicandIsolated from Foods)

VIRAL AND RICKETTSIW DISEASESEpidemiologicalEvidence of Foodborne TransmissionViral Diseases which Could Possible be Transmittedby Foods but Proof Is Lacking

PAMSITIC DISEASESAlways or Usually Transmitted by FoodsUsually Transmitted by Other Means but Sometimes Foodborne

FUNGAL DISEASES ‘-MycotoxicosesMushroomsMycotic Infections

PLANT TOXICANTS AND TOXINSAlkaloidsGlycosidesToxalbuminsResinsOther Toxicants, Toxins, and Allergens

TOXIC ANIM4LSFishShellfishOther Marine AnimalsNon-Marine Animals

POISONOUS CHEMICALSMetallic’ContainersIntentional AdditivesIncidental and Accidental Food AdditivesAllergens or Enzyme DeficienciesFood-Drug CombinationsRadionuclides

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227

16

1717

18

-I.-ILL

2229

33333742

4343474.9

5050

5454536062

646465687576

76

-INDEX

INTRODUCTION

This reference sununarizesthe following data: etiologic agents and theirnature, sources and important reservoirs, epidemiology, foods frequentlyinvolved in outbreaks, specimens and samples to take in outbreak investigations,laboratory approaches, and general control measures of foodbome diseases thathave been reported throughout the world, This information is organized farrapid review and comparison of the same kinds of data about different diseases.

Diseases transmitted by foods are frequently classified either as poison-ings or infections. Poisonings are caused by ingesting toxicants that arefound in tissues of certain plants and animals, metabolic products (toxins)formed and excreted by microorganisms(such as bacteria, fungi, or algae) whilethey multiply in foods, or poisonous substances that may be intentionally orincidentally added to foods as a result of producing, processing, transporting,or storing. Infections are caused by the entrance of pathogenic microorganismsinto the body and the reaction of body tissues to their presence or to thetoxins they generate within the body. Intestinal infections may be manifestedby in vivo enterotoxin production or mucosal penetration. After mucosal penetra-tion, the organisms multiply in the mucosa or pass into other tissues. Thisclassification is illustrated on the adjacent page.

In this reference, the foodborne diseases are classified on the basis ofthe type of agent responsible for the illness--bacterial, viral and rickettsial,parasitic (protozoan,cestodes, nematodes, trematodes, helrninths),fungal(mycotoxinor mushroom), poisonous plants, toxic animals, poisonous chemicals,and radionuclides. In each category, the diseases of contemporary importanceare listed first. The relative importance of each disease does, however, varyfrom time to time and from place to place. This reference also includes diseasesthat have been reported as being foodborne even though proof is lacking. It also

includes diseases in which the causative agent has been found in foods buttransmission through foods is unknown, and enteric diseases in which the trans-mission through foods is possible. No attempt has been made to discuss allpoisonous plants, poisonous chemicals, or radionuclides. Only those plantsthat are used as food or mistaken for food and those that illustrate adifferent class of poison are reviewed. There has been no attempt to list allfoods that have been incriminated as vehicles in outbreaks. Except in thecases of rare diseases, only foods of primary public health importance are listed.

The symptoms’of each disease are usually in the order either of theiroccurrence or of their predominance. Individual cases, however, will not mani-fest all the symptoms and, in some cases, additional signs.and symptoms willoccur. The incubation period (latent period in the case of poisonings) of adisease is the time from ingestion of the contaminated food until the firstsymptoms appear; individual cases may have incubation periods that vary fromthe stated times. Control measures are listed in order of.their relativeimportance. A complete bibliography of the literature from which this summarywas compiled would be extensive, so only one or a few specific references foreach disease are given, along with review articles and texts in each category.

Blank spaces in the text indicate that the appropriate information isinsignificant, is unknown, or has not come to the attention of the author.The author encourages comment on missing diseases and .information”andsub-mission of additional data for revision of the summary.

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