Bacterial
| Etiological Agent | Incubation Period | Clinical Syndrome | Pathogenic Mechanism | Laboratory Diagnosis or Confirmation | Suspected 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 |