Foodborne Illness

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Foodborne illness
Other names: Foodborne disease[1]
  • Top: Salmonella

  • Bottom: Poorly stored food in refrigerator
SpecialtyInfectious disease
SymptomsNausea, Vomiting[2]
CausesBacillus cereus, Escherichia coli, Listeria monocytogenes, Staphylococcus aureus[3]
Risk factorsImproper handling, or food storage[4]
Diagnostic methodStool test, sigmoidoscopy[5]
Differential diagnosisAcute hepatitis,acute cholecystitis,mesenteric ischemia[5]
PreventionConsists of good food safety practices,such as via cooking food sufficiently[6] [7]
TreatmentAntiemetics, antibiotic therapy[5]
Frequency600 million cases of foodborne diseases (and 420,000 deaths)[8]

Foodborne illness (also foodborne disease or food poisoning)[9] is any illness resulting from the spoilage of contaminated food by pathogenic bacteria, viruses, or parasites that contaminate food,[6] as well as prions (the agents of mad cow disease), and toxins such as aflatoxins in peanuts, poisonous mushrooms[10]

Symptoms vary depending on the cause but often include vomiting, fever, and aches, and may include diarrhea. Bouts of vomiting can be repeated with an extended delay in between, because even if infected food was eliminated from the stomach in the first bout, microbes, like bacteria, can pass through the stomach into the intestine and begin to multiply. Some types of microbes stay in the intestine.[11][10][12]

For contaminants requiring an incubation period, symptoms may not manifest for hours to days, depending on the cause and on quantity of consumption. Longer incubation periods tend to cause those affected to not associate the symptoms with the item consumed.[13]

Signs and symptoms[edit | edit source]

In terms of the presentation of Foodborne illness we find the following, though this is not an exaustive list:[2]

Causes[edit | edit source]

See also: Pathogen

Foodborne illness 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. There is a consensus in the public health community that regular hand-washing is one of the most effective defenses against the spread of foodborne 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.[4][14]

Furthermore, foodborne illness can be caused by a number of chemicals, such as pesticides, medicines, and natural toxic substances such as vomitoxin, poisonous mushrooms or reef fish.[15]

Bacteria[edit | edit source]

Scanning electron micrograph of Listeria monocytogenes.

Bacteria are a common cause of foodborne illness. The United Kingdom, in 2000, reported the individual bacteria involved as the following: Campylobacter jejuni 77.3%, Salmonella 20.9%, Escherichia coli O157:H7 1.4%, and all others less than 0.56%.[16] 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 agent. Toxins from bacterial infections are delayed because the bacteria need time to multiply. As a result, symptoms associated with intoxication are usually not seen until 12–72 hours or more after eating contaminated food. However, in some cases, such as Staphylococcal food poisoning, the onset of illness can be as soon as 30 minutes after ingesting contaminated food.[17]

Most common bacterial foodborne pathogens are:

Other common bacterial foodborne pathogens are:[3]

Less common bacterial agents:

Enterotoxins[edit | edit source]

See also: Botulism

In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by enterotoxins (exotoxins targeting the intestines). Enterotoxins can produce illness even when the microbes that produced them have been killed. Symptom appearance varies with the toxin but may be rapid in onset, as in the case of enterotoxins of Staphylococcus aureus in which symptoms appear in one to six hours.[28] This causes intense vomiting including or not including diarrhea (resulting in staphylococcal enteritis), and staphylococcal enterotoxins (most commonly staphylococcal enterotoxin A but also including staphylococcal enterotoxin B) are the most commonly reported enterotoxins although cases of poisoning are likely underestimated.[29] It occurs mainly in cooked and processed foods due to competition with other biota in raw foods, and humans are the main cause of contamination as a substantial percentage of humans are persistent carriers of S. aureus.[29] The CDC has estimated about 240,000 cases per year in the United States.[30]

Enterotoxins include the following:[31]

The rare but potentially deadly disease botulism occurs when the anaerobic bacterium Clostridium botulinum grows in improperly canned low-acid foods and produces botulin, a powerful paralytic toxin.[32]

Pseudoalteromonas tetraodonis, certain species of Pseudomonas and Vibrio, and some other bacteria, produce the lethal tetrodotoxin.[33][34]

Emerging foodborne pathogens[edit | edit source]

Mycotoxins and alimentary mycotoxicoses[edit | edit source]

The term alimentary mycotoxicosis refers to the effect of poisoning by mycotoxins through food consumption. The term mycotoxin is usually reserved for the toxic chemical products produced by fungi that readily colonize crops. Mycotoxins sometimes have important effects on human and animal health. For example, an outbreak which occurred in the UK in 1960 caused the death of 100,000 turkeys which had consumed aflatoxin-contaminated peanut meal. In the USSR in World War II, 5,000 people died due to alimentary toxic aleukia (ALA).[37] [38]The common foodborne Mycotoxins include:

  • Aflatoxins – originating 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 predominantly targets the liver, which will result in necrosis, cirrhosis, and carcinoma.[39][40] In the US, the acceptable level of total aflatoxins in foods is less than 20 μg/kg, except for Aflatoxin M1 in milk, which should be less than 0.5 μg/kg.[41] The official document can be found at FDA's website.[42][43]
  • Altertoxins – are those of alternariol (AOH), alternariol methyl ether (AME), altenuene (ALT), altertoxin-1 (ATX-1), tenuazonic acid (TeA), and radicinin (RAD), originating from Alternaria spp. Some of the toxins can be present in sorghum, ragi, wheat and tomatoes.[44][45][46] Some research has shown that the toxins can be easily cross-contaminated between grain commodities, suggesting that manufacturing and storage of grain commodities is a critical practice.[47]
  • Citrinin[48]
  • Citreoviridin[49]
  • Cyclopiazonic acid[50]

Viruses[edit | edit source]

Rotavirus

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 noroviruses are the most common foodborne illness. Foodborne viral infection are usually of intermediate, 1–3 days incubation period, causing illnesses which are self-limited in otherwise healthy individuals[76][77]

These are viral foodborne infections:

Parasites[edit | edit source]

Taenia saginata

Most foodborne parasites are zoonoses.[84]

Natural toxins[edit | edit source]

Several foods can naturally contain toxins, many of which are not produced by bacteria, plants in particular may be toxic. In evolutionary terms, animals, for example, can escape being eaten by fleeing; plants can use only passive defenses such as poisons and distasteful substances, for example capsaicin in chili peppers and pungent sulfur compounds in garlic and onions. [89]

These are the following:

Some plants contain substances which are toxic in large doses, but have therapeutic properties in appropriate dosages.[105][106]

Other pathogenic agents[edit | edit source]

"Ptomaine poisoning" [edit | edit source]

Ptomaine poisoning was a myth that persisted in the public consciousness, in newspaper headlines, and legal cases as an official diagnosis, decades after it had been disproven scientifically in the 1910s.[108]

In the 19th century, the Italian chemist Francesco Selmi, of Bologna, introduced the generic name ptomaine (from Greek ptōma, "fall, fallen body, corpse") for alkaloids found in decaying animal and vegetable matter, especially (as reflected in their names) putrescine and cadaverine.[109] The 1892 Merck's Bulletin stated, "We name such products of bacterial origin ptomaines; and the special alkaloid produced by the comma bacillus is variously named Cadaverine, Putrescine, etc."[110] While The Lancet stated, "The chemical ferments produced in the system, the... ptomaines which may exercise so disastrous an influence"[111].

Tainted potato salad sickening hundreds at a Communist political convention in Massillon, Ohio,[112] and aboard a Washington DC cruise boat in separate incidents during a single week in 1932 drew national attention to the dangers of so-called "ptomaine poisoning" in the pages of the American news weekly, Time.[113] Another newspaper article from 1944 told of more than 150 persons being hospitalized in Chicago with ptomaine poisoning apparently from rice pudding served by a chain of restaurants.[114]

Mechanism[edit | edit source]

Molecular mechanism of H2 receptor activation by exogenous histamine in SFP(Scombroid food poisoning)[115]

Incubation period[edit | edit source]

The delay between the consumption of contaminated food and the appearance of the first symptoms of illness is called the incubation period. This ranges from hours to days , depending on the agent, and on how much was consumed. If symptoms occur within one to six hours after eating the food, it suggests that it is caused by a bacterial toxin.[116][13][117][1]

The long incubation period of many foodborne illnesses tends to cause those affected to attribute their symptoms to gastroenteritis.[118]

During the incubation period, microbes pass through the stomach into the intestine, attach to the cells 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 bloodstream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe.[119]

Infectious dose[edit | edit source]

The infectious dose is the amount of agent that must be consumed to give rise to symptoms of foodborne illness, and varies according to the agent and the consumer's age and overall health. Pathogens vary in minimum infectious dose; for example, Shigella sonnei has a low estimated minimum dose of < 500 colony-forming units (CFU) while Staphylococcus aureus has a relatively high estimate.[120]

In the case of Salmonella a relatively large inoculum of >50,000 organisms is necessary to produce symptoms in healthy human volunteers, as Salmonellae are very sensitive to acid. An unusually high stomach pH level greatly reduces the number of bacteria required to cause symptoms.[121][122]

Unaccustomed to organisms[edit | edit source]

Foodborne illness often occurs as travelers' diarrhea in persons whose gut microbiota is unaccustomed to organisms endemic to the visited region, this effect of microbiologic naivete is compounded by any food safety lapses in the food's preparation.[123]

Diagnosis[edit | edit source]

Sigmoidoscopy

In terms of the diagnosis of foodborne illness we find that a physical exam and a review of certain factors that may cause the symptoms being experienced are done, as well as:[5][124]

Differential diagnosis[edit | edit source]

The DDx of Foodborne illness is as follows:[5]

Prevention[edit | edit source]

Prevention is mainly the role of the state, through the definition of strict rules of hygiene and a public services of veterinary surveying of animal products in the food chain, from farming to the transformation industry and delivery (shops and restaurants). This regulation includes:[6] [7][125][126]

  • 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;
  • Enforcement of hygiene procedures ;
  • Power of control and of law enforcement of veterinarians.

In August 2006, the United States Food and Drug Administration approved phage therapy which involves spraying meat with viruses that infect bacteria, and thus preventing infection. This has raised concerns, because without mandatory labelling consumers would not be aware that meat and poultry products have been treated with the spray.[127]

At home, prevention mainly consists of good food safety practices. Many forms of bacterial poisoning can be prevented by cooking food sufficiently, and either eating it quickly or refrigerating it effectively.[6]

Techniques that help prevent food borne illness in the kitchen are hand washing, rinsing produce,[128] preventing cross-contamination, proper storage, and maintaining cooking temperatures. In general, freezing or refrigerating prevents virtually all bacteria from growing, and heating food sufficiently kills parasites, viruses, and most bacteria. Bacteria grow most rapidly at the range of temperatures between 40 and 140 °F (4 and 60 °C), called the "danger zone". Storing food below or above the "danger zone" can effectively limit the production of toxins. For storing leftovers, the food must be put in shallow containers for quick cooling and must be refrigerated within two hours. When food is reheated, it must reach an internal temperature of 165 °F (74 °C) or until hot or steaming to kill bacteria.[129]

Treatment[edit | edit source]

The management of Foodborne illness in an affected individual, is done via the following:[5]

Epidemiology[edit | edit source]

Age-distribution of Disability Adjusted Life Years for 31 hazards contributing to the global burden of foodborne disease for 2010

Asymptomatic subclinical infection may help spread these diseases, particularly Staphylococcus aureus, Campylobacter, Salmonella, Shigella, Enterobacter, Vibrio cholerae, and Yersinia.[120] For example, as of 1984 it was estimated that in the United States, 200,000 people were asymptomatic carriers of Salmonella.[120]

Infants[edit | edit source]

Main article: Infant food safety

Globally, infants are a group that is especially vulnerable to foodborne disease. The World Health Organization has issued recommendations for the preparation, use and storage of prepared formulas. Breastfeeding remains the best preventive measure for protection from foodborne infections in infants.[130]

United States[edit | edit source]

In the United States, using FoodNet data from 2000 to 2007, the CDC estimated there were 47.8 million foodborne illnesses per year (16,000 cases for 100,000 inhabitants)[131] with 9.4 million of these caused by 31 known identified pathogens.[132]

  • 127,839 were hospitalized (43 per 100,000 inhabitants per year).[133][134][135]
  • 3,037 people died (1.0 per 100,000 inhabitants per year).[134][135]

United Kingdom[edit | edit source]

According to a 2012 report from the Food Standards Agency, there were around a million cases of foodborne illness per year.[136]

  • 20,000 were hospitalized (32 per 100,000 inhabitants);[136][137]
  • 500 people died (0.80 per 100,000 inhabitants).[136][137]

France[edit | edit source]

This data pertains to reported medical cases of 23 specific pathogens, as opposed to total population estimates of all foodborne illness for the United States.In France, for 750,000 cases :[138][139][140]

  • 70,000 people consulted in the emergency department of a hospital (113 per 100,000 inhabitants);
  • 113,000 people were hospitalized (182 per 100,000 inhabitants);
  • 460 people died (0.75 per 100,000 inhabitants).

Australia[edit | edit source]

A study by the Australian National University, published in November 2014, found in 2010 that there were an estimated 4.1 million cases of foodborne gastroenteritis acquired in Australia on average each year, along with 5,140 cases of non-gastrointestinal illness. The study was funded by the Australian Department of Health, Food Standards Australia New Zealand and the NSW Food Authority.[142]

The main causes are Norovirus, pathogenic Escherichia coli, Campylobacter spp. and non-typhoidal Salmonella spp., although the causes of approximately 80% of illnesses were unknown. Approximately 25% of the 15.9 million episodes of gastroenteritis that occur in Australia were estimated to be transmitted by contaminated food. This equates to an average of approximately one episode of foodborne gastroenteritis every five years per person. Data on the number of hospitalisations and deaths represent the occurrence of serious foodborne illness. Including gastroenteritis, non-gastroenteritis and sequelae, there were an estimated annual 31,920 hospitalisations due to foodborne illness and 86 deaths due to foodborne illness circa 2010.A main aim of this study was to compare if foodborne illness incidence had increased over time. In this study, similar methods of assessment were applied to data from circa 2000, which showed that the rate of foodborne gastroenteritis had not changed significantly over time. Two key estimates were the total number of gastroenteritis episodes each year, and the proportion considered foodborne. In circa 2010, it was estimated that 25% of all episodes of gastroenteritis were foodborne. By applying this proportion of episodes due to food to the incidence of gastroenteritis circa 2000, there were an estimated 4.3 million episodes of foodborne gastroenteritis circa 2000, although credible intervals overlap with 2010.[142][143]

This study replaces a previous estimate of 5.4 million cases of foodborne illness in Australia every year, causing:[144]

  • 18,000 hospitalizations
  • 120 deaths (0.5 deaths per 100,000 inhabitants)
  • 2.1 million lost days off work
  • 1.2 million doctor consultations
  • 300,000 prescriptions for antibiotics.

Most foodborne disease outbreaks in Australia have been linked to raw or minimally cooked eggs or poultry.[145] The Australian Food Safety Information Council estimates that one third of cases of food poisoning occur in the home.[146]

Outbreaks[edit | edit source]

Main article: Deadliest foodborne illness incidents
Further information: List of foodborne illness outbreaks in the United States

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, the majority of cases originate from commercial food facilities. 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 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. Outbreaks can also be identified by public health staff when there are 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 different from district to district. It is estimated that a low percentage of outbreaks are detected.[147][10][148]

Society and culture[edit | edit source]

United Kingdom[edit | edit source]

In postwar Aberdeen (1964) a large-scale (>400 cases) outbreak of typhoid occurred, caused by contaminated corned beef which had been imported from Argentina. The corned beef was placed in cans and because the cooling plant had failed, cold river water from the Plate estuary was used to cool the cans. One of the cans had a defect and the meat inside was contaminated. This meat was then sliced using a meat slicer in a shop in Aberdeen, and a lack of cleaning the machinery led to spreading the contamination to other meats cut in the slicer. These meats were then eaten by the people of Aberdeen who then became ill.[149][150]

Serious outbreaks of foodborne illness since the 1970s prompted key changes in UK food safety law. These included the death of 19 patients in the Stanley Royd Hospital outbreak[151] and the bovine spongiform encephalopathy (BSE, mad cow disease) outbreak identified in the 1980s. The death of 21 people in the 1996 Wishaw outbreak of E. coli O157[152][153] was a precursor to the establishment of the Food Standards Agency which, according to Tony Blair in the 1998 white paper A Force for Change Cm 3830, "would be powerful, open and dedicated to the interests of consumers".[154]

In May 2015, for the second year running, England's Food Standards Agency devoted its annual Food Safety Week to – "The Chicken Challenge". The focus was on the handling of raw chicken in the home and in catering facilities in a drive to reduce the high levels of food poisoning from the campylobacter bacterium. Anne Hardy argues that widespread public education of food hygiene can be useful, particularly through media (TV cookery programmes) and advertisement. She points to the examples set by Scandinavian societies.[155]

United States[edit | edit source]

FDA
Main article: Food safety in the United States

In 2001, the Center for Science in the Public Interest petitioned the United States Department of Agriculture to require meat packers to remove spinal cords 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.[156]

None of the US Department of Health and Human Services targets[157] regarding incidence of foodborne infections were reached in 2007.[158]

A report issued in June 2018 by NBC's Minneapolis station using research by both the CDC and the Minnesota Department of Health concluded that foodborne illness is on the rise in the U.S.[159]

Organizations[edit | edit source]

The World Health Organization Department of Food Safety and Zoonoses (FOS) provides scientific advice for organizations and the public on issues concerning the safety of food. Its mission is to lower the burden of foodborne disease, thereby strengthening the health security and sustainable development of Member States. Foodborne and waterborne diarrheal diseases kill millions of 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.[160][161]

International Food Safety Authorities Network (INFOSAN)[edit | edit source]

The International Food Safety Authorities Network (INFOSAN) is a joint program of the WHO and FAO. INFOSAN has been connecting national authorities from around the globe since 2004, with the goal of preventing the international spread of contaminated food and foodborne disease and strengthening food safety systems globally. [162]

Prioritisation of foodborne pathogens[edit | edit source]

The Food and Agriculture Organization of the United Nations and The World Health Organization have published a global ranking of foodborne parasites using a multicriteria ranking tool concluding that Taenia solium was the most relevant, followed by Echinococcus granulosus, Echinococcus multilocularis, and Toxoplasma gondii.[163] The same method was used regionally to rank the most important foodborne parasites in Europe ranking Echinococcus multilocularis of highest relevance, followed by Toxoplasma gondii and Trichinella spiralis.[164]

Regulatory steps[edit | edit source]

Food may be contaminated during all stages of food production and retailing, in order to prevent viral contamination, regulatory authorities in Europe have enacted several measures:

  • European Commission Regulation (EC) No 2073/2005 of November 15, 2005[165]
  • European Committee for Standardization (CEN): Standard method for the detection of norovirus and hepatitis A virus in food products [166]
  • CODEX Committee on Food Hygiene (CCFH): Guideline for the application of general principles of food hygiene for the control of viruses in food[167]

See also[edit | edit source]

Notes[edit | edit source]

1.^ NIH news has been used for this source, due to its useful text
2.^ It should be noted that this list indicates figures from more that one particular year

References[edit | edit source]

 This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.

  1. ↑ "Foodborne diseases". www.who.int. Archived from the original on March 12, 2024. Retrieved April 18, 2024.
  2. ↑ 2.0 2.1 "Food Poisoning Symptoms". Centers for Disease Control and Prevention. October 24, 2023. Archived from the original on March 20, 2024. Retrieved March 31, 2024.
  3. ↑ 3.0 3.1 CDC (March 18, 2020). "Foodborne Germs and Illnesses". Archived from the original on September 5, 2015. Retrieved August 9, 2022.{{cite web}}: CS1 maint: uses authors parameter (link)
  4. ↑ 4.0 4.1 "10 Dangerous Food Safety Mistakes". Centers for Disease Control and Prevention. October 24, 2023. Archived from the original on March 31, 2024. Retrieved March 31, 2024.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 Switaj, Timothy L.; Winter, Kelly J.; Christensen, Scott R. (September 1, 2015). "Diagnosis and Management of Foodborne Illness". American Family Physician. pp. 358–365. Archived from the original on August 18, 2022. Retrieved March 31, 2024.
  6. ↑ 6.0 6.1 6.2 6.3 "Foodborne Illness - Frequently Asked Questions". US Centers for Disease Control and Prevention. Archived from the original on March 3, 2011. Retrieved July 3, 2016.
  7. ↑ 7.0 7.1 Todd, E (July 16, 2020). "Food-Borne Disease Prevention and Risk Assessment". International journal of environmental research and public health. 17 (14). doi:10.3390/ijerph17145129. PMID 32708573. Archived from the original on May 14, 2023. Retrieved April 1, 2024.
  8. ↑ "Estimating the burden of foodborne diseases". www.who.int. Archived from the original on January 9, 2024. Retrieved March 31, 2024.
  9. ↑ "food poisoning" at Dorland's Medical Dictionary
  10. ↑ 10.0 10.1 10.2 Bintsis, T (2017). "Foodborne pathogens". AIMS microbiology. 3 (3): 529–563. doi:10.3934/microbiol.2017.3.529. PMID 31294175. Archived from the original on October 28, 2023. Retrieved April 5, 2024.
  11. ↑ Bold, J; Rostami, K (2011). "Foodborne, food related illness and role of the healthcare professionals". Gastroenterology and hepatology from bed to bench. 4 (1): 1–2. PMID 24834147. Archived from the original on April 5, 2024. Retrieved April 2, 2024.
  12. ↑ "Food Poisoning - NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on February 13, 2024. Retrieved April 11, 2024.
  13. ↑ 13.0 13.1 Chai, S. J.; Gu, W.; O'Connor, K. A.; Richardson, L. C.; Tauxe, R. V. (2019). "Incubation periods of enteric illnesses in foodborne outbreaks, United States, 1998–2013". Epidemiology and Infection. 147. doi:10.1017/S0950268819001651. PMID 31587689. Archived from the original on April 9, 2024. Retrieved April 8, 2024.
  14. ↑ "NCEZID: Foodborne Disease (Food Poisoning) | What We Do | NCEZID | CDC". www.cdc.gov. December 18, 2019. Archived from the original on October 23, 2023. Retrieved April 3, 2024.
  15. ↑ U.S. Food and Drug (2021). "Chemicals, Metals & Pesticides in Food". Food and Drug Administration. Archived from the original on July 28, 2022. Retrieved August 9, 2022.{{cite web}}: CS1 maint: uses authors parameter (link)
  16. ↑ "Reducing the risk from E. coli 0157 – controlling cross-contamination". Food Standards Agency, United Kingdom. February 2011. Archived from the original on April 16, 2014. Retrieved 14 August 2016.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  17. ↑ "Staphylococcal Food Poisoning". U.S. Centers for Disease Control and Prevention. Archived from the original on February 8, 2016. Retrieved July 3, 2016.
  18. ↑ Humphrey T, O'Brien S, Madsen M (July 2007). "Campylobacters as zoonotic pathogens: a food production perspective". International Journal of Food Microbiology. 117 (3): 237–57. doi:10.1016/j.ijfoodmicro.2007.01.006. PMID 17368847.
  19. ↑ "Foodborne Illness: What Consumers Need to Know". USDA.gov. Archived from the original on March 2, 2021. Retrieved August 14, 2016.
  20. ↑ Kiu R, Caim S, Painset A, Pickard D, Swift C, Dougan G, et al. (October 2019). "Clostridium perfringens in England and Wales over a 7-year period indicates distribution of clonal toxigenic strains in multiple outbreaks and extensive involvement of enterotoxin-encoding (CPE) plasmids". Microbial Genomics. 5 (10): e000297. doi:10.1099/mgen.0.000297. PMC 6861862. PMID 31553300.
  21. ↑ Tribe IG, Cowell D, Cameron P, Cameron S (2002). "An outbreak of Salmonella typhimurium phage type 135 infection linked to the consumption of raw shell eggs in an aged care facility". Communicable Diseases Intelligence Quarterly Report. 26 (1): 38–9. PMID 11950200. Archived from the original on February 17, 2014.
  22. ↑ "Salmonella Infection (salmonellosis) and Animals". Centers for Disease Control and Prevention. Archived from the original on July 4, 2007. Retrieved August 12, 2007.
  23. ↑ Doyle MP, Erickson MC (June 2006). "Reducing the carriage of foodborne pathogens in livestock and poultry". Poultry Science. 85 (6): 960–73. doi:10.1093/ps/85.6.960. PMID 16776463.
  24. ↑ Gally DL, Stevens MP (January 2017). "Microbe Profile: Escherichia coli O157:H7 - notorious relative of the microbiologist's workhorse" (PDF). Microbiology. 163 (1): 1–3. doi:10.1099/mic.0.000387. PMID 28218576. Archived (PDF) from the original on October 31, 2020. Retrieved October 10, 2022.
  25. ↑ Karch H, Tarr PI, Bielaszewska M (October 2005). "Enterohaemorrhagic Escherichia coli in human medicine". International Journal of Medical Microbiology. 295 (6–7): 405–18. doi:10.1016/j.ijmm.2005.06.009. PMID 16238016.
  26. ↑ Béjaoui, A; Ben Abdallah, I; Maaroufi, A (July 29, 2022). "Brucella spp. Contamination in Artisanal Unpasteurized Dairy Products: An Emerging Foodborne Threat in Tunisia". Foods (Basel, Switzerland). 11 (15). doi:10.3390/foods11152269. PMID 35954037. Archived from the original on April 24, 2024. Retrieved April 22, 2024.
  27. ↑ "Q fever". www.ecdc.europa.eu. July 8, 2010. Archived from the original on February 25, 2024. Retrieved April 22, 2024.
  28. ↑ Food poisoning: Causes Archived December 27, 2012, at the Wayback Machine. Mayo Clinic.
  29. ↑ 29.0 29.1 Argudín MÁ, Mendoza MC, Rodicio MR (July 2010). "Food poisoning and Staphylococcus aureus enterotoxins". Toxins. 2 (7): 1751–73. doi:10.3390/toxins2071751. PMC 3153270. PMID 22069659.
  30. ↑ Staphylococcus aureus: A Problem When Food Is Left Out Too Long Archived November 23, 2015, at the Wayback Machine. Ohio State University Extension HYG-5564-11].
  31. ↑ Stiles, Bradley G.; Pradhan, Kisha; Fleming, Jodie M.; Samy, Ramar Perumal; Barth, Holger; Popoff, Michel R. (September 2014). "Clostridium and Bacillus Binary Enterotoxins: Bad for the Bowels, and Eukaryotic Being". Toxins. 6 (9): 2626–2656. doi:10.3390/toxins6092626. ISSN 2072-6651. Archived from the original on November 23, 2023. Retrieved April 4, 2024.
  32. ↑ Jarosz, Aleksandra; Grenda, Tomasz; Goldsztejn, Magdalena; Kozak, Beata; Kwiatek, Krzysztof (November 7, 2022). "Potential risk of botulinum neurotoxin -producing clostridia occurrence in canned fish". Journal of Veterinary Research. 66 (4): 605–611. doi:10.2478/jvetres-2022-0060. Archived from the original on December 27, 2023. Retrieved April 7, 2024.
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