Bacterial

Summary of Foodborne and Waterborne Disease Characteristics

Bacterial summary of foodborne and waterborne disease characteristics
Etiological AgentIncubation PeriodClinical SyndromePathogenic MechanismLaboratory Diagnosis or ConfirmationSuspected food or epidemiologically implicated vehicle of transmission
Bacillus cereus: Vomiting toxin 1-6 hours Vomiting, occasional diarrhea; fever uncommon Emetic toxin Isolation of organism from stool OR Isolation of organism from epidemiologically implicated food Rice, cereals, beans, potato, pasta, milk
Bacillus cereus: Diarrheal toxin 6-24 hours Diarrhea, abdominal cramps, vomiting in some patients; fever uncommon Enterotoxin Isolation of organism from stool OR Isolation of organism from epidemiologically implicated food Rice, cereals, beans, potato, pasta, milk
Brucella species Several days to several months, usually>30 days Weakness, fever, headache, sweats, chills, arthralgia, weight loss, splenomegaly Penetration, spread Isolation of organism from blood or bone marrow; serological testing Consumption of unpasteurized milk or dairy products
Campylobacter species 2-10 days, usually 2-5 days Diarrhea (often bloody), abdominal pain, fever Unknown Isolation of organism from stool Isolation of organism from epidemiologically implicated food Poultry, poultry products, pork
Clostridium botulinum 2 hours to 8 days, usually 12-24 hours Illness of variable severity; double or blurred vision, weakness, neuromuscular paralysis which is usually descending and bilateral, may progress rapidly Neurotoxin (heat labile) Detection of botulinum toxin in serum, stool, gastric contents or implicated food OR Isolation of organism from stool or intestine Improperly preserved vegetables, meat, fish
Clostridium perfringens 6-24 hours Diarrhea, abdominal cramps; vomiting and fever uncommon Enterotoxin Isolation of organisms in stool OR Demonstration of enterotoxin in the stool OR Isolation of organism from epidemiologically implicated food Meat, poultry, beans
Escherichia coli: Enterohemorrhagic (E. coli O157:H7 and other serotypes that produce Shiga toxins – EHEC) 1-10 days, usually 4-5 days; approximately 6% go on to develop hemolytic-uremic syndrome (HUS) (children) or thrombotic thrombocytopenic purpura(TTP) (adults) Diarrhea (often bloody), abdominal cramps (often severe), little or no fever. Acute renal failure in HUS or TTP Cytotoxin Isolation of organism from clinical specimen
OR
Isolation of organism from epidemiologically implicated food
Beef (especially ground), raw vegetables, unpasteurized fruit juice
Escherichia coli: Enterotoxigenic E. coli (ETEC) 6-48 hours Diarrhea, abdominal cramps, nausea; vomiting and fever less common Enterotoxin Isolation and serotyping of organism from stool demonstrated to produce heat-stable and/or heat-labile enterotoxin Beef (especially ground), raw vegetables, unpasteurized fruit juice
Escherichia coli: Enteropathogenic E. coli (EPEC) Variable Diarrhea, abdominal cramps, fever Adherence Isolation and serotyping of organism from stool Beef (especially ground), raw vegetables, unpasteurized fruit juice
Escherichia coli: Enteroinvasive E. coli (EIEC) Variable Diarrhea (may be bloody),fever, abdominal cramps Mucosal invasion Isolation and serotyping of organism from stool Beef (especially ground), raw vegetables, unpasteurized fruit juice
Listeria monocytogenes: Invasive disease 2-6 weeks Meningitis, meningoencephalitis neonatal sepsis, abortions, stillbirths Penetration, spread Isolation of organism from blood or cerebrospinal fluid and isolation of same serotype and subtype of organism from implicated food Cheese (especially soft varieties) unpasteurized milk and dairy products, meat, raw vegetables
Listeria monocytogenes: Diarrheal disease 9-32 hours Diarrhea, often with fever and abdominal cramps Penetration, spread Isolation of organism from stool and epidemiologically implicated food of the same serotype Cheese (especially soft varieties) unpasteurized milk and dairy products, meat, raw vegetables
Salmonella serotype typhi 3-60 days, usually 7-14 days Fever, anorexia, malaise, headache and myalgia; sometimes diarrhea and constipation Penetration, spread Isolation of organism of same serotype and subtype from clinical specimens OR Isolation of organism from epidemiologically implicated food Only found in humans but not part of usual bowl flora Person-to person spread by oral- fecal route by ingestion of food or water contaminated with human excreta
Nontyphoidal salmonellosis 6-hours-10 days, usually 6-48 hours Diarrhea, often with fever and abdominal cramps Mucosal invasion Isolation of organism of same serotype and subtype from clinical specimens OR Isolation of organism from epidemiologically implicated food Beef, eggs and egg products, melons, raw milk and dairy products, pork, poultry, salads containing protein ingredients, smoked meat and sausage, unpasteurized fruit juice
Staphylococcus aureus 30 minutes-8 hours, usually 2-4 hours Vomiting, diarrhea Enterotoxin (heat stable) Isolation of organism of same phage type/ molecular subtype from stool or vomitus OR Detection of same serotype of enterotoxin in epidemiologically implicated food Cream filled baked goods, custards, cheese, corned beef, fermented meats, ham, raw milk, pasta, pork, poultry, smoked meats
Streptococcus group A 1-4 days Fever, pharyngitis, scarlet fever, upper respiratory infection Penetration, spread Isolation of organism of same M or T type from throat OR Isolation of organism of same M or T type from epidemiologically implicated food Raw milk and dairy products, salads containing protein ingredients
Vibrio cholerae O1 or O139Non-O1 and Non -O139 1-5 days Watery diarrhea, often accompanied by vomiting Enterotoxin Isolation of toxigenic organism from stool or vomitus OR Significant rise in vibriocidal, bacterial agglutination, or antitoxin antibodies in acute- and early convalescent-phase sera in persons not recently immunized OR Isolation of toxigenic organism from epidemiologically implicated food Molluscan shellfish and other fish, crustacea, spread by Fecal-oral route, ingestion of contaminated water
Vibrio cholera: Non-O1 and Non -O139 1-5 days Watery diarrhea Enterotoxin Isolation of toxigenic organism from stool or vomitus OR Significant rise in vibriocidal, bacterial agglutination, or antitoxin antibodies in acute- and early convalescent-phase sera in persons not recently immunized OR Isolation of toxigenic organism from epidemiologically implicated food Molluscan shellfish and other fish, crustacea, spread by Fecal-oral route, ingestion of contaminated water
Vibrio parahaemolyticus 4-30 hours Diarrhea Unknown Isolation of Kanagawa-positive organism from stool OR Isolation of Kanagawa-positive organism from epidemiologically implicated food Crustacea, fish, molluscan shellfish