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Costs and implications of food safety flaws
1 Costs and implications of food safety flaws
General Objectives
Index
- Reconhecer a necessidade de segurança alimentar
1 FORBORNE ILLNESSES 3
2 COSTS AND IMPLICATIONS OF FOODBORNE ILLNESSES 4
3 FOODBORNE INTOXICATIONS 15
3.1 BIOLOGICAL INTOXICATIONS 15 3.1.1 CAUSED BY BACTERIA 15 3.1.2 CAUSED BY VIRUSES 20 3.1.3 CAUSED BY PARASITES 20 3.1.4 CAUSED BY PRIONS 21 3.1.5 CAUSED BY OTHER BIOLOGICAL TOXINS 21 3.2 CHEMICAL INTOXICATIONS 24 3.2.1 CAUSED BY PERSISTENT ORGANIC POLLUTANTS (POP) 26 3.2.2 CAUSED BY HEAVY METALS 26
4 BIBLIOGRAFIA 27
2 Costs and implications of food safety flaws
Costs and implications of
food safety flaws
According to the World Health
Organization (WHO), each year
30% of the habitants of
industrialized countries get
sick due to the ingestion of
food contaminated by
microorganisms. In Portugal,
with a population of
approximately 11 million (2001
Census), the estimate is about
3 million, and although some
cases are not reported or do
not require medical assistance,
they end up having some
economical impacts, such as
direct expenses (due to the
necessity of medical assistance
or medicine), and other type
of expenses (loss of revenue,
work absence, etc.).
These situations frequently
occur due to lack of basic food
handling care, especially in
preparation and retail selling
places. The lack of care during
food and food product handling
can have other consequences,
not only health wise but
economically. Each year
millions of tons of products are
removed from vending points
or retained even before they
become available to the
consumer, due to various
problems, the main cause is
the presence of substances
that can bring harm to the
consumer.
There are many agents that
cause foodborne illnesses:
bacteria or its toxins; toxins
produced by mold; viruses;
natural or introduced chemical
substances during production
and/or processing; etc. The
presence of these agents can
be avoided or limited, by
simply following some easy to
apply rules.
Knowing or recognizing the
economic implications of food
safety flaws during food
handling or food and/or food
product preparation, expenses
wise such as health expenses,
should and must allow people
to become conscious about the
necessity to be rigorous about
the application of basic
measures, necessary to
prevent the introduction of
food and/or food products in
the market that may cause
illnesses.
3 Costs and implications of food safety flaws
1 Forborne illnesses
According to the World Health
Organization, a foodborne
illness is generally a disease of
an infectious or toxic nature,
caused by agents that enter
the body through the ingestion
of food or water.
It is estimated that about 30%
of the population of
industrialized countries suffer
this kind of illness per year.
a. Food infections
Food infections occur by
ingesting food contaminated
with a pathogenic
microorganism that is capable
of growing and colonizing the
gastrointestinal tract.
Symptoms start to show after a
period of incubation, initiated
by food ingestion and may last
a couple of hours, various days
or weeks, because this is the
time needed for the
microorganism to multiply and
to carry out its pathogenic
action.
b. Food Poisoning
Food poisoning occurs by
ingesting a food that contains
poisonous substances. These
substances can be of different
origins:
- Food itself:
In certain conditions, some
vegetable products (potatoes,
tomato, etc.), animals
(namely some fish), or other
organisms (poisonous
mushrooms), produce toxins
that are ingested when these
foods are eaten.
- Microbiological:
Sometimes, we eat food
where a microorganism
previously grew and produced
toxins that end up being
ingested along with the food.
The pathogenic agent could
have disappeared before
ingesting the food but it toxins
can still be present.
- Chemical
The prolonged consumption of
food contaminated with
chemical toxins, such as heavy
metals or dioxins, may result
in the accumulation of these
toxins, which in the
middle/long term may trigger
various diseases of an
oncological or neurological
nature, among others.
Generally, these toxins are
transported by water, air, soil
or by materials in contact with
food.
c. Food Intoxication
Food intoxication can occur by
the ingestion of food that
contains pathogenic
microorganisms. Once they get
into the intestine, these
microorganisms develop and
produce toxins that are
responsible for symptoms.
4 Costs and implications of food safety flaws
Table 1 – Classification of foodborne diseases
Infection Ingestion of food contaminated with harmful
microorganisms that grow and colonize the digestive
system.
Poisoning Ingestion of food that contains poisonous symptoms.
Intoxication Ingestion of food with harmful microorganisms that
grow and produce toxins in the digestive system.
2 Costs and implications of foodborne illnesses
Sometimes, just like it happens
in this text, we use the term
intoxication to designate any
type of foodborne illness,
whether if it’s an infection,
poisoning or intoxication.
Most of these illnesses have
common symptoms (Diarrhea,
abdominal cramps, nausea and
dehydration) what makes it
difficult to differentiate them
exclusively based on symptoms.
These symptoms are also
characteristic of other illnesses
that are not food related which
can lead to wrong diagnosis.
In 1994 it was estimated by the
World Health Organization that
between 6,5 and 33 million
people got sick due to the
presence of microorganisms in
food, resulting in about 9 000
unnecessary deaths.
For most victims, the
consequences of the sickness
are “only” discomfort and
absence from work. For others,
especially preschoolers, elderly
that require health care and
those that have a frail immune
system, foodborne illnesses can
result in more severe
consequences and eventually
be life threatening.
If you are ever a “victim” of
food poisoning, most likely it’s
going to be an experience that
you will not like to repeat. The
symptoms are not at all
enjoyable and generally include
one or more of the following:
diarrhea, vomiting, headaches,
nausea and dehydration.
Whatever the impact that food
intoxications may have on each
one of us as an individual
person, the annual cost in
terms of suffering, reduced
productivity and medical
expenses are estimated in
hundreds of millions of Euros.
In the United States of America
(USA) the predicted costs for
the year 2000 were 6.9 billion
dollars, only counting the costs
associated to the cases caused
5 Costs and implications of food safety flaws
by five pathogenic
microorganisms.
Collecting information about
the incidence of food poisoning
is normally complicated due to
various factors. The main factor
seems to be undeclared cases
by persons responsible for this
(doctors), or by not associating
the symptoms to food
poisoning. In many cases, and
although these may result in
severe damage or even death,
people don’t look for medical
assistance due to the presence
of weak symptoms.
Some pathogenic
microorganisms do not only
spread by food but also by
water and even person to
person, making it more difficult
to associate them to food.
Aside from these difficulties,
there are some available data
that allow us to assess the real
impact that these situations
may have. Figure 1 shows the
evolution of the number of food
poisoning cases reported in the
United Kingdom (UK) between
1985 and 2004.
The situation in Portugal,
where the “habit” of not
registering such occurrences
exists (only cases of typhoid
fever, paratyphoid fever,
salmonellosis, brucellosis and
shigellosis are listed as
mandatory communicable
diseases), is not very different
from the situation verified in
other countries, as shown in
figure 2 as a result of data
obtained from the “8th Report
1999-2000” of the World Health
Organization (WHO)
(Surveillance Programme for
Control of Foodborne Infections
and Intoxications in Europe,
2003) and data from the Dr.
Ricardo Jorge National Health
Institute (NHI) about identified
outbreaks by the Institute in
Lisbon in 2001 to 2005. These
data are frequently used to
estimate the real number of
cases of foodborne diseases.
There are many areas along the
food production chain, from the
“field” to the final consumer,
where food can be
contaminated and/or poorly
handled. That is why it is
important for all areas, from
production to the final
consumer, to be monitored and
controlled in a way to reduce
the risks of causing foodborne
diseases.
Many of the existing cases
happen due to poor handling
practices in the places where
meals are served and in retail
vending posts (Figure 3).
In these establishments,
monitoring and controlling risks
becomes more critical.
6 Costs and implications of food safety flaws
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
0 20000 40000 60000 80000 100000 120000
78921
79087
81551
95551
98076
96866
105060
105596
94925
92603
91129
76711
72139
59497
59721
59214
49864
34800
28887
23556
nº de casos
Figure 1 – Evolution of the number of food poisoning cases reported in the (UK).
Source: Health protection Agency Centre for infections/ Communicable Disease Surveillance Centre, Health Protection Scotland and Communicable Disease
Surveillance Centre.
7 Costs and implications of food safety flaws
0
50
100
150
200
250
300
350
400
450
2001 2002 2003 2004 2005
surtos e casos afectados hospi talizados
FIGURE 2 – Food Intoxications 2001-2005
Evolution of the number of food poisoning cases reported in Portugal that occurred between 2001
and 2005. The data only refers to the cases registered by NHI – Lisbon. Data given by Dr. Rosario
Novais (NHI-Lisbon).
The analysis of data that refer
to contamination in
acquisition/consumption
places, allow us to verify that it
is in restaurants where most of
the outbreaks and cases of food
intoxication have occurred.
Although the 2001-2005 data
indicates an increase of cases
related to the ingestion of food
prepared/consumed at home,
surveillance and control of the
referred establishments should
not be obscured by competent
entities responsible for this
matter.
Epidemiological data of
repeatedly occurred outbreaks,
identified 5 main risk factors,
related to food handlers’
behaviour and food
handling/preparation practices
in establishments that prepare
and sell food, as being the ones
that most contribute to food
poisoning cases:
1- Maintaining food at
improper temperatures;
2- Inadequate
processing/cooking;
3- Use of contaminated
equipment;
4- Food from unsafe sources;
5- Lack of food handlers’
personal hygiene.
8 Costs and implications of food safety flaws
36%
32%
26%
3%
3%
0,0% 10,0% 20,0% 30,0% 40,0%
pastelaria
serv.catering
restaurantes
refeitório
casa particular
FIGURE 3 – Food Intoxications 2001/2005; acquisition/consumption places
Distribution of food poisoning cases by the diverse food handling places. The data only refers to the
registered cases at the NHI-Lisbon. Data given by Dr. Rosario Novais (NHI-Lisbon).
FIGURE 4 - Food intoxications (1999-2000) – contributing factors
Data available in Portugal, regarding main risk factors, also indicate the previously referred factors
as the main factors responsible for foodborne intoxications (figure 4).
Home
Canteens
Restaurants
Catering services
Pastries
Anticipated food preparation
Inadequate refrigeration
Inadequate maintenance temperature
Inadequate cooking
Food obtained from unsafe sources
Mination by infected people
9 Costs and implications of food safety flaws
The implications related to the
lack of personal hygiene when
manipulating food products are
not limited to the previously
mentioned. The presence of
some microorganisms or other
contaminants in food
frequently leads to the
withdrawal of great quantities
of food products from the
market. In Europe, there exists
the RAPID ALERT SYSTEM FOR
FOOD AND FEED (RASFF) which
aims to group and disseminate
all cases in which were
detected foods that may cause
risk to consumers in one way or
another. The legal basis for the
RASFF is Regulation (EC) n. º
178/2002, whose article 50
establishes the rapid alert
system for food as a network
that involves all State
Members, the Commission and
the European Food Safety
Authority (EFSA). This network
emits two types of alerts:
-Alert notification:
Whenever, in any State
Member, a food is detected on
the market that in any way
may put at risk the consumer,
for this, rapid action is
required –
withdrawal/retrieval form the
market.
-Information notification:
Whenever, in any State
Member, a food is detected
that is not yet found on the
market, and in any way may
put the consumer at risk, for
this the remainder State
Members do not need to take
immediate measures (in most
cases, this is related to
imported and rejected
products at border controls of
the State Members).
When we compare data from
2004 to previous years, it is
evident that the tendency is
the existence of a greater
number of notifications (Figure
5).
This increase may not mean
that there are more risky
products for consumers, but
that surveillance is tighter. As
previously referred, the
existence of a greater number
of notifications referred by a
certain country (figure 6),
doesn’t mean that the
situation regarding food safety
in that country is bad. On the
contrary, it can mean, that
that the entities responsible
food safety surveillance are
more attentive/active (greater
number of inspections) in that
country.
10 Costs and implications of food safety flaws
0
6000
5000
4000
3000
2000
1000
1999 2000 2001 2002 2003 2004
alerta ad.
alerta
informação
informação ad.
Figure 5 - Evolution of emitted notifications by RASFF from 1999 to 2004
Data obtained from: Annual report on the functioning of the RASFF. 2004
itália (I) 576
espanha (E) 305
reino unido (RU) 231holanda (H) 146frança (F) 124
grécia (G) 95
noruega (N) 85bélgica (B) 59
dinamarca (D) 53
finlândia (Fi) 52
suécia (S) 44república checa (RC) 41
austria (Au) 32
eslovénia (Es) 27
portugal (P) 25
eslováquia (El) 24
chipre (C) 23
hungria (Hu) 22
lituânia (L) 21
polónia (Po) 17
irlanda (Ir) 16
letónia (Lt) 15
luxemburgo (Lu) 13
malta (M) 8
estónia (Et) 6
islãndia (Is) 2
liechtenstein (Li) 0
alemanha (A) 526
Figure 6 – Number of notifications according to each Country
Distribution of total number of notifications, registered by RASFF in 2004. Distribution by Country
of origin: Annual report on the functioning of the RASFF.2004.
11 Costs and implications of food safety flaws
According to the RASFF report,
most of the alert notifications
that occurred in 2004 were due
to the presence of undefined
chemical contaminants,
followed by microbiological
contaminants (figure 7).
No data was found about the
number of withdrawals verified
in these countries neither
about the quantity (tons or kg)
of retrieved products.
In Portugal, it has been
possible to verify a greater
activity of the entity
responsible for this matter
(ASAE), although there is no
data available exclusively on
food safety; based on the
presented data it is possible to
deduce that violating rules
involves great costs. The data
presented by ASAE does not
make reference to the cause of
the withdrawal/retrieval from
the market. In the meantime
and according to data referring
to the United States, each year
millions of tons of food
products are withdrawn (figure
9).
Just between January 2005 and
June 2006, 130 000 tons of
products were declared for
withdrawal, being that 98%
(126 000 tons) of the
withdrawals were due to
microbiological originated
problems.
químicas (outras)
microbiológicas
micotoxinas
residúos de produtos médicos/vet.
parasitas
não determinadas
corpos estranhos
metais pesados
microrganismos patogénicos
outros
FIGURE 7 - Alert notifications according to type of risk (hazard)
Distribution of total number of notifications, registered by RASFF in 2004. Distribution by Country
of origin: Annual report on the functioning of the RASFF.2004.
12 Costs and implications of food safety flaws
Table II – Operational activity until November 30th (ASAE)
JAN FEV MAR APR MAY JUN JUL AGU SEP OCT NOV TOTAL
Food safety 12 9 71 46 89 100 109 94 157 168 158 1013
Economic inspection 11 24 65 37 67 98 117 110 152 166 125 972
Inspected operators 319 1026 1668 1529 1770 1320 2468 1750 1709 1970 1851 17381
Suspended activity 3 1 22 29 58 61 51 35 55 53 80 448
Crime procedure 1 15 35 47 69 122 75 110 50 55 132 711
CO procedures 111 199 640 430 796 573 598 570 651 694 702 5966
Detentions 0 2 17 14 17 17 21 12 11 29 24 164
Violation Rate 35% 21% 40% 31% 49% 52% 27% 39% 41% 38% 45% 38%
Apprehended material Weight (ton) 125,40 7,62 262,71 501,15 49,96 98,49 215,86 86,97 85,08 249, 25 220,82 1903,28
Volume
(m3) 0,00 0,05 179,16 1148,39 627,57 0,04 33,91 35,15
25949,0
2 73,97 139,48 28186,70
Quantity
(x1000) 1,8 5,9 8,7 84,4 141,1 285,2 1757,5 50,4 53,4 67,1 113,0 2568,50
Value
(million €) 181,2 128,0 676,2 1742,8 1701,1 681,3 1123,1 768,8 8917,5 868 1058,9 17846,8
Source: www.asae.pt
13 Costs and implications of food safety flaws
Figure 8 - Press release emitted by ASAE (14/02/07) regarding apprehended food products.
Source: www.asae.pt
14 Costs and implications of food safety flaws
The presented data refers to
the withdrawal notifications
emitted by the Food Safety
and Inspection Service (FSIS) -
public health agency of the
United States Department of
Agriculture, responsible for
surveillance of commercialized
meat, eggs and egg products
and these only refer to a total
of 33 withdrawal notifications,
of which 22 were due to
microbiological problems and
the remainder to other
problems (6 – presence of
allergic substances;
1 – insufficient labeling; 1 –
presence of pieces of metal; 1
– presence of pieces of bone; 1
– Overprocessing; 1 – presence
of pesticides). In the
meantime, it’s important to
point out that this isn’t the
only entity in the United States
responsible for the emission of
food product withdrawal
notifications. The Food and
Drug Administration is another
entity responsible for the
emission of notifications of
other products that are not
meat or egg based (cereals and
cereal products, nuts, etc.).
Figure 9 – Volume of withdrawals in the USA (2005-2006)
Volume of withdrawals (tons of products) verified in the USA between 2005 and June 2006. These
are classified according to the cause of withdrawal. Source: http://www.fsis.usda.gov/
Microbiological
Others
15 Costs and implications of food safety flaws
3 Foodborne Intoxications
Currently there are 200 known
illnesses transmitted by food.
The causes of foodborne
illnesses include viruses,
bacteria, toxins, parasites,
metals, etc. Symptoms vary
from a simple gastroenteritis
to neurological (botulism),
hepatic (hepatitis A), and
kidney failure (E. coli 0157:H7)
problems that can be life
threatening.
Surveillance and collection of
concrete data about foodborne
intoxications is generally
complicated, because many
factors are involved, as
previously mentioned.
3.1 Biological Intoxications
Bacteria are responsible for
most foodborne intoxications,
not only in number but in
frequency, although other
agents such as viruses or
parasites may also cause them.
For this reason, this document
will emphasize more on the
aspects related to biological
intoxications.
When we are studying
foodborne intoxications, it is
convenient to know what foods
are more frequently associated
to outbreaks or microbiological
food poisoning cases, as well
as, which are the main toxic or
infectious agents present in
those foods. It is still
convenient to know what are
the main symptoms related to
the main cases. Table III
presents some foods frequently
involved in food poisoning
cases and the main associated
agents.
3.1.1 Caused by bacteria
Bacteria are simple structured
unicellular organisms, which
allow them to multiply very
rapidly in the presence of
nutrients and favorable
temperature, pH, humidity and
oxygen concentration
conditions. In some cases, 20
minutes are sufficient for the
number of bacteria to
duplicate. This means that an
initial number of 10 bacteria in
a certain food, with favorable
conditions, will multiply in a
way that they will become 640
bacteria in two hours.
Generally, foodborne bacterial
infections are referred to
simply as food infections. The
main symptoms are diarrhea,
abdominal cramps, vomiting,
dehydration and sometimes
fever. These usually show up
after an incubation period of a
couple of hours or various days
and can last during a period
that goes from a day to a
week. In the last decades,
Salmonella has been the origin
of most food infection cases.
These generally result from the
ingestion of eggs, chicken and
turkey and other meats, raw
milk and chocolate.
16 Costs and implications of food safety flaws
Table III - Food and agents generally associated to foodborne intoxications
Food
Generally associated microorganisms
Raw seafood
Vibrio sp., Hepatitis A virus, Norovirus (Norwalk-like viruses)
Raw eggs
Salmonella
Undercooked meat
Salmonella and Campylobacter, Escherichia coli STEC, Clostridium
perfringens
Unpasteurized milk or juice
Salmonella, Campylobacter, Yersinia, STEC
Unpasteurized soft cheese
Salmonella, Campylobacter, Yersinia, Listeria sp., STEC
Homemade conserves
Clostridium botulinum (botulism)
Hotdogs, ham, etc.
Listeria sp.
17 Costs and implications of food safety flaws
However, the prevalence of
Campylobacter jejuni
infections (supposedly present
in raw milk, raw or
undercooked poultry and in
drinking water) have increased
in the last years in a way, that
in some countries Salmonella
has become its rival. Even
though it still has a low
incidence rate, the appearance
of infections caused by Listeria
monocytogenes (caused by
raw milk, pasteurized milk
contaminated afterwards,
cheeses, ice cream and
salads), have caused some
preoccupations over the last
decades, because these
bacteria can cause severe
damage, sometimes fatal, to
infants, children, pregnant
women, elderly and people
with compromised immune
systems. These bacteria are
also able to grow at low
temperatures such as in a
refrigerator.
A bacterial intoxication
occurs when the growth of a
microorganism in the
gastrointestinal tract is related
to the production of toxins,
being Clostridium perfringens
one of the most common
responsible agents. The term
intoxication needs to be
interpreted with some
precaution, because it is used
many times to generally
describe a set of infections and
food poisonings, as was
previously mentioned and used
in this document.
The consumption of food
where bacteria previously grew
and produced toxins, which
end up being eaten along with
the food, can trigger food
poisoning. The toxins act
directly over the
gastrointestinal tract and
symptoms appear few hours
later (two to four) after the
ingestion of the contaminated
food.
Poisonings caused by Yersinia
enterocolitica and some
Escherichia coli strains have
increased over the last years,
although there exist other
bacteria such as
Staphylococcus aureus,
Clostridium botulium or
Bacillus cereus related to food
poisonings.
In bacterial intoxications,
there are four agents (some
authors consider only three)
that are frequently responsible
for collective intoxication
cases: Salmonella; Clostridium
perfringens; S.aureus and
Campylobacter. Table IV
presents the main
characteristics of diseases
caused by the main bacterial
agents, relatively to
symptoms, incubation periods
and food most frequently
associated to diverse
microorganisms.
18 Costs and implications of food safety flaws
Table IV – Characteristics of main foodborne Intoxications
Microorganism Type of illness Symptoms Probable food Incubation period Duration
Campylobacter jejuni Infection
Diarrhea, sometimes followed by
fever; abdominal pain, nausea;
headaches and muscle pain
Raw poultry and other food
contaminated by raw poultry,
unpasteurized milk, untreated water
2-5 days Various days
Clostridium perfringes Intoxication Intense abdominal cramps;
diarrhea
Meat and meat products, sauces,
products rich in protein 8-16 hours 24 hours
Cryptosporidium
parvum Infection
Severe watery diarrhea; abdominal
pains, low fever, pulmonary and
trachea problems
Contaminated water; food
contaminated with fecal matter;
fruits and vegetable contaminated
with water.
1-6 weeks
2-4 days (can
go up to 4
weeks)
Escherichia coli
(various types: EPEC;
EIEC; ETEC; and EHEC)
Infection
Watery diarrhea, abdominal
cramps, low fever, nausea, MAL
ESTAR
Contaminated water, undercooked
minced meat, unpasteurized milk and
juice; pieces of melon.
12-72 hours
48-288 hours
(EHEC)
6 – 72 hours
2-8 days
(EHEC)
Listeria monocytogenes Infection
Nausea, vomiting, diarrhea, with
possible progression for
headaches, confusion, loss of
balance and convulsions, may
cause spontaneous abortion
Ready to eat foods contaminated
with bacteria, including milk, cheese,
ice cream, raw vegetables, raw
fermented hotdogs, raw and cooked
poultry and raw and smoked fish.
Unknown; can go
from some days to
3 weeks
Various days
to weeks
Salmonella spp. Infection
Abdominal cramps, diarrhea,
fever, headaches
Animal based food; other food
contaminated due to the contact with
feces, raw animal based food or
infected handlers. Poultry, eggs, raw
milk and meat are often found
contaminated.
12-72 hours 3 – 4 weeks
19 Costs and implications of food safety flaws
Table IV – Characteristics of main foodborne Intoxications
Microorganism Type of illness Symptoms Probable food Incubation period Duration
Shigella spp. Infection Fever, abdominal pain and cramps,
diarrhea.
Food with fecal contamination. 12-48 hours 5 – 7 days
Giardia lamblia Infection Diarrhea; abdominal cramps;
nausea
Water and food that were in contact
with contaminated water 1-2 weeks 2 – 6 weeks
Trichinella spiralis Infection Nausea; diarrhea; vomiting;
fatigue; fever; abdominal cramps
Raw and undercooked pork and pork
products 1 – 2 days Some months
*Bacillus cereus Poisoning
Watery diarrhea, cramps
Nausea and vomiting
Cooked products left uncovered;
milk, meat, vegetables, fish; rice and
food rich in starch.
Cooked products left uncovered;
milk, meat, vegetables, fish; rice and
food rich in starch
8 – 20 hours
1 – 6 hours
24 hours
24 hours
Clostridium botulinum Poisoning
Lethargy, weakness, dizziness,
double vision; difficulty talking,
swallowing and/or breathing,
paralysis, possible death
Inadequate processing of homemade
conserves; hotdogs, marine products,
canned minced garlic; honey 12 – 36 hours
Various days
after an
antitoxin
treatment
Staphylococcus aureus Poisoning
Nausea, vomiting, abdominal
cramps
Contaminated food due to inadequate
handling and storage temperatures –
meat and meat products; poultry and
egg products; salads rich in proteins,
sandwich fillings, pastry products
with creams and fillings.
1 – 6 hours 24 – 48 hours
B. cereus produces two types of toxins – emetic and diarrheal
20 Costs and implications of food safety flaws
3.1.2 Caused by viruses
Viruses are infectious
agents with a very simple
organization: a molecule
of a nucleic acid (DNA or
RNA) enclosed within a
protein coat. They are
much smaller than
bacteria and require a
living cell for replication,
from a specific species,
that will act as a host.
Some viruses cause
foodborne illnesses.
Although they don not
multiply on food (because
they are specific for
human cells), their
destruction does not
occur unless the food is
properly prepared. Its
specificity also implicates
that the viruses that
infect animals, such as
the swine pest virus, do
not represent any danger
to human health, being
its control justified only
as a question of animal
health.
The viruses most
frequently related to
foodborne illnesses are
the Hepatitis A and
hepatitis E, rotavirus
(main cause of infant
diarrhea) and the Norwalk
family viruses (cause
gastroenteritis).
Mollusks such as oysters,
and other shellfish,
caught near the coast in
polluted areas, are the
main foods involved in
foodborne viruses.
Fruits and salads are
another group of foods
frequently related to
intoxications. The
contamination of these
products normally occurs
during their production
due to the use of human
excrements as fertilizers.
Any food that is not
reheated after being
manipulated by an
infected individual is a
potential infection
conveyer.
3.1.3 Caused by Parasites
Vermin and protozoa are
parasites; these are
organisms that live on or
inside another organism
(host). They benefit from
this association by
obtaining nutrients while
the host is harmed.
Foodborne illnesses
provoked by these
parasites are a lot less
frequent than the ones
caused by bacteria. These
parasites, which are a lot
bigger than bacteria, can
grow and reach the adult
state in the human
gastrointestinal tract, or
can be directly ingested
by eating contaminated
animal tissue. In some
cases, the symptoms can
last various weeks,
disappearing or reducing
at the end of this time to
reappear later on.
Among the main parasites
that cause foodborne
illnesses we can find
21 Costs and implications of food safety flaws
Giardia lamblia (G.
intestinalis),
Cryptosporidium parvum
(protozoa) and Trichinella
spiralis (vermin). Table VI
presents the main
characteristics of the
illnesses caused by these
parasites.
3.1.4 Caused by prions
A prion is an infectious
protein particle that is
presumed to be the cause
of Transmissible
Spongiform
Encephalopathies (TSEs),
like the Bovine
Spongiform
Encephalopathy (BSE –
mad cow disease) and its
human variant, sheep and
goat scrapie and the
Creutzfeldt-Jacob disease
(CJD). The prion is
constituted by a modified
protein that when in
contact with a healthy
protein it modifies it
converting it in a
pathogenic protein, which
in its turn will modify a
healthy protein and so
forth causing a chain
reaction.
3.1.5 Caused by other
biological toxins
All mycotoxins, toxins
produced by algae and all
toxins produced by food
are put together in this
group.
Mycotoxins result from
the growth of known
molds. The Aflatoxins
produced by Aspergillus
flavus and Aspergillus
parasiticus, in walnuts,
peanuts and other oily
seeds, are the most
common and most serious
mycotoxins. Some have a
strong cancerous action.
Other toxins, such as
Ochratoxin A, patulin and
fumonisim of other
species of the fungal
genus, like Penicillium
and Fusarium are a lot
less toxic.
Mushroom intoxications
(by poisonous fungi) can
result from eating any
kind of the many existing
species. The intoxication
potential can vary within
the same species, in
different moments of the
growth season and how
they are prepared.
Muscarin is a dangerous
substance that can be
present in some
mushroom species (Figure
10).
Plant and shrub
intoxications can result
from eating its leaves and
fruit, whether wild or
not. The fava beans can
cause the red blood cells
to rupture (favism), in
persons genetically
susceptible. The roots or
green sprouts that grow
beneath the soil and
contain solanin A may
cause light nauseas,
vomiting, diarrhea and
weakness.
22 Costs and implications of food safety flaws
Figure 10 - Some mushrooms of the Inocybe genus – Inocybe lanuginose and Inocybe bongardii
Photos from: http://www.dipbot.unict.it/funghi/photogallery/page_04.htm
23 Costs and implications of food safety flaws
Table V – Characteristics of foodborne illnesses caused by viruses
Virus Incubation period Symptoms Duration of the
illness
Most involved
Food
Hepatitis A 28 days Weakness, diarrhea,
cramps, jaundice 2 weeks to 3 months Not specified
Hepatitis E 6 weeks Weakness, diarrhea,
cramps, jaundice 1 month Water
Rotavirus 1 – 3 days
Vomiting, watery
diarrhea and
moderate fever
48 hours Not specified
Norwalk 14 – 48 hours
Nausea, vomiting,
abdominal cramps,
diarrhea, fever,
myalgia and
headaches
12 hours to 3 days Not specified
Astrovirus 10 – 72 hours
Vomiting, watery
diarrhea and
moderate fever
2 to 9 days Not specified
Table VI – Characteristics of foodborne illnesses caused by parasites
Parasite Incubation period Symptoms Duration of the
illness
Most involved
Food
Giardia lamblia (G.
intestinalis) 2 days
Diarrhea,
nausea,
abdominal
cramps and
flatulency
Months (without
treatment)
Water,
salmon, fruits
and
vegetables
Cryptosporidium
parvum 10 days
Diarrhea,
abdominal
cramps, low
fever and
headaches
? Water
Trichinella spiralis
1-2 days
2-8 weeks (larvae
infection)
Nausea,
diarrhea,
vomiting,
fatigue, fever
and abdominal
cramps
?
Ingested raw
or
undercooked
pork and meat
products
24 Costs and implications of food safety flaws
Solanin is naturally found
in potatoes; the quantity
of solanin increases when
potatoes are exposed to
light as they turn a
greenish colour. This
toxin is not destroyed by
cooking and can be fatal.
Ergot of rye poisoning
occurs when the cereal is
contaminated by the
fungus Claviceps
purpurea (Figure 11). This
fungus is responsible for
an illness called ergotism,
also known as “Ergot
poisoning” and “Saint
Anthony fire”.
Marine Intoxications can
be caused by fish or
seafood. Normally fish
intoxications are a result
from one of three toxins:
ciguatera, tetrodotoxin,
or saxitoxin.
The ciguatera toxin is
produced by certain
microscopic algae, which
are eaten by ocean finned
fish of the sub-tropical or
tropical regions, and
accumulates in their
meat. Among the fish
most commonly
associated to ciguatera
are: Dusky Grouper,
Barracuda, red,
triggerfish e mackerel.
The saxitoxin is produced
in some algae known to
cause red waves. This
toxin is filtered and
retained by mussels,
oysters and other shellfish
without causing any harm
to them.
However, the ingestion of
contaminated shellfish by
humans can provoke a
very acute intoxication
known as Paralytic
Shellfish Poisoning. This
toxin, just like ciguatera,
continues alive, even
after it is cooked and
eaten.
The tetrodotoxin is a
strong marine biotoxin,
produced by a large
number of animal
species, but in particular
by the globe fish. This
fish that is mostly found
in the Japanese seas
constitutes a much
appreciated meal in
Asiatic countries. Because
of its high toxicity it is
also used by many to
commit suicide.
Intoxication by histamine
that is produced by fish
like mackerel, tuna and
yellowfin tuna happens
when the fish tissue
begins to decompose
after their capture
liberating high levels of
histamine. After the
ingestion of this toxin, it
causes immediate redness
of the face. The levels of
histamine found in fish
products are regulated at
the European level.
3.2 Chemical
Intoxications
Intoxication by
contaminants can affect
people that have ingested
25 Costs and implications of food safety flaws
Figure 11 – Picture of infected cereal by the Claviceps purpurea fungi.
Photos: http:/www.wetterzentrale.de/np/galerie/index.php
26 Costs and implications of food safety flaws
unwashed fruits and
vegetables pulverized
with arsenic, lead or
organic insecticides or
that have ingested acidy
liquids served in glassed
lead recipients or food
stored in recipients
covered with cadmium.
The main non biological
agents responsible for
food poisoning are called
POP (Persistent organic
pollutants) and heavy
metals.
3.2.1 Caused by
Persistent organic
pollutants (POP)
POPs are composts that
accumulate in the
environment, human body
and animals. The most
known examples are
dioxins that are
undesirable sub-products
of some industrial
processes and of
incineration residue, PCBs
used in the production of
electrical equipments
industry and
hexachlorobenzene used
as an additive in the
paper industry,
production of PVC or as
an intermediate agent of
the manufacturing of
other substances.
3.2.2 Caused by heavy
metals
Lead, mercury and
cadmium are heavy
metals that have mostly
contributed to cases of
prolonged or chronic
poisoning through food
(including drinking
water). Lead and mercury
cause neurological
damage to infants and
children and cadmium
causes kidney damage,
normally observed on the
elderly. Just like the POP,
these contaminate food
through air, water and
soil pollution.
The Chinese restaurant
syndrome.
Contradicting what is
usually heard about what
is vulgarly known as the
Chinese restaurant
syndrome, it isn’t a type
of food poisoning caused
by chemical products. It’s
rather a hypersensitive
reaction to monossodic
glutamate (MSG), a
substance that is used to
intensify the taste of food
that is normally used in
Chinese cuisine. In
persons susceptible to
monossodic glutamate it
may cause a pressure
sensation on the face,
chest pain and burning
sensations all over the
body. The quantity of
monossodic glutamate
capable of provoking
these symptoms varies
from person to person.
27 Costs and implications of food safety flaws
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International commission on Microbiological Specifications
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Jay, J. M.; “Modern Food Microbiology”; 5 ed.; Chapman
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Lacasse, D., “Introdução à Microbiologia Alimentar”;
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Mead, P.S.; Slutske.r L.; Dietz, V.; McCaig, L. F.; Bresee,
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1997
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2006
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28 Costs and implications of food safety flaws