Tuesday, 11 August 2015


10 Foodborne Illnesses That Will Make You Wish You Were Dead
By Maria Trimarchii,
How Stuff Works, 3 August 2015.

All it takes is just one drop of Salmonella-contaminated liquid from improperly handled or stored raw chicken to contaminate another food or liquid. That contamination can happen either through direct contact, or indirectly through contaminated kitchen utensils or cutting boards. About 48 million people - that's about one in six, and most under the age of 5 or over 65 - get sick with a foodborne illness every year in the U.S. Of those, 128,000 are hospitalized, and 3,000 die [source: NIAID].

Foodborne illnesses are caused by different types of pathogens, including commonly thought-of sources such as bacteria, viruses and parasites, in addition to the ones that don't come to mind as often, such as pollutants and toxins. The most common foodborne pathogens are Salmonella [top image], responsible for 38 percent of reported foodborne infections, followed by Campylobacter, responsible for 35 percent of reported infections. Both of those cause gastrointestinal problems and fever, and both are usually self-limiting, lasting about 10 days or less.

While none of that sounds like a good time, here we have 10 foodborne illnesses that do more than keep you on the bathroom floor for a night or two. These pathogens paralyze your muscles, cause explosive and watery diarrhoea, and may even make you think hot feels cold and cold feels hot.

10. Botulism

Credit: Phil Moyer/Flickr

Botulism is a foodborne bacterial infection caused by the bacterium Clostridium botulinum [pictured above]. Well, technically the body's reacting to the toxins produced by this bacterium. Adult intestinal toxemia, infant botulism and wound botulism are also caused by this bacterium, and it's the muscle-paralyzing neurotoxin produced by this bacterium that's used in Botox injections.

Botulism begins with fatigue, muscle weakness and vertigo, and it quickly progresses to abdominal pain and swelling, blurry vision, diarrhoea, difficulty swallowing, double vision, (severe) dry mouth, nausea and vomiting. As the neurotoxin builds in the body, paralysis begins to set in: The autonomic nervous system begins to fail, there is symmetrical descending paralysis and cranial nerve paralysis, and respiratory muscle weakness leads to respiratory failure. Not only do you wish you were dead, but without prompt treatment, botulism may actually kill you.

Foodborne botulism is commonly caused by improperly canned food, but it may also grow in foods that are allowed to sit at room temperature for too long. The incubation period - the time between exposure to the bacterium (eating contaminated food) and the first symptom of infection - is typically as few as 12 to 72 hours, but it may range between four hours and eight days. More than 90 percent of people infected with Clostridium botulimun will have symptoms of the illness within three to five days [source: Chan-Tack and Bartlett]. Infants infected with Clostridium botulinum, however, won't normally develop symptoms until three to 30 days after exposure [source:].

The good news: The bacterium is vulnerable to high heat. Bringing a home-canned sauce to a boil for 10 minutes before eating it, for example, will kill these bacteria if they're present.

Treating botulism requires the administration of an antitoxin - those with fastest access to the antitoxin, and using it before the body is completely paralyzed, may prevent their paralysis from worsening and reduce their recovery time [source: WHO]. Botulism infections can be fatal, even after treatment, though less than 5 percent of those who are treated die. Left untreated, 60 percent of those infected with the neurotoxin die [source: Arizona Department of Health Services].

9. Cholera

Credit: mostly*harmless/Flickr

Although cholera infections are rare in the U.S. and other developed countries, developing nations have between 3 million and 5 million cases of cholera reported and between 100,000 and 120,000 deaths annually. Most of those cases are clustered in Africa, Haiti and Southeast Asia [source: WHO]. Severe cases, estimated to be 5 to 10 percent of those affected, can be fatal if treatment isn't received promptly [source: CDC].

Cholera is a foodborne illness caused by the bacterium Vibrio cholerae [pictured above], and it occurs after consuming food or water that's been contaminated with faeces from a person infected with the bacterium. Contamination may happen through inadequate hand washing and hygiene or in areas with inadequate sanitation and water treatment. Cases of cholera in developed nations are rare, and they're most often associated with eating contaminated raw oysters.

Cholera's hallmark, profuse diarrhoea, won't appear until two to three days after exposure to the bacterium.

Vibrio cholerae is an enterotoxin, which means it's a bacterium that infects the intestines. The toxins produced by this bacterium attack the cells in the lining of the intestine, causing those cells to release large amounts of water. With nowhere to go but out, the infection progresses to generous amounts of foul-smelling watery diarrhoea "that resembles rice water" [source: Davis]. The accompanying fast and significant fluid loss causes severe dehydration, and treatment primarily involves rehydration.

8. Ciguatera Fish Poisoning (CFP)

Credit: Cooking SoftwareOz/Flickr

While nausea and vomiting are classic symptoms of common foodborne illness such as Escherichia coli (E. coli) or Salmonella enterocolitis infections, tingling toes and fingers are a sign of a more severe form of foodborne illness called ciguatera fish poisoning.

The single-celled ciguatoxin-producing protozoan, the dinoflagellate Gambierdiscus toxicus, lives on algae in tropical, coral-reef waters. Small herbivorous fish eat this algae as part of their diet. As nature would have it, these small fish are part of part of the diet of larger, carnivorous fish - and so on through the food chain. Eventually, we arrive at the large reef fish we commonly consume: barracuda, black grouper, blackfin snapper, cubera snapper, dog snapper, greater amberjack, hogfish, horse-eye jack, king mackerel and yellowfin grouper [source: CDC].

And while ciguatoxin is harmless to fish, it's fatal to humans. It's impossible to detect ciguatoxin contamination by a fish's colour, odour or taste. And cooking fish at high temperatures or freezing it won't remove the toxins. This biotoxin affects the body's gastrointestinal system first, before causing neurological symptoms such as a "pins and needles" feeling or tingling, called paresthesias. The classic symptom of this infection is neurological: paradoxical temperature reversal, which means hot things feel cold and cold things feel hot. Cardiovascular symptoms are also common and may include hypotension and pulmonary edema.

Symptoms may appear as quickly as 15 minutes after ingesting the toxin, although, most commonly symptoms appear between six and 12 hours. There is no treatment, and while symptoms have been known to last for days, for some people it can take years to recover.

7. 'Crypto'

Credit: Nephron/Wikimedia Commons

In Milwaukee, Wisconsin, in 1993, more than 400,000 people were sickened after ingesting cryptosporidiosis-contaminated drinking water [source: Osewe et al.].

Cryptosporidiosis [pictured above], called "crypto" for short, is a waterborne illness caused by single-celled coccidian parasites called Cryptosporidium, and it's responsible for as many as 7.3 percent of all the diarrheal illnesses reported in developed countries. Prevalence of cryptosporidiosis is greater in developing regions that may not have reliable access to clean water sources and sanitation [source: Pearson]. There are more than 26 known Cryptosporidium species; among them, Cryptosporidium parvum and Cryptosporidium hominis, which are responsible for most human cases of the infection.

It takes as few as two to 10 cryptosporidia to cause cryptosporidiosis, an infection in the small intestine. Symptoms usually appear an average of seven days after becoming infected. Watery diarrhoea is the most common symptom of a crypto infection. Other symptoms of infection include abdominal cramping, dehydration, fever, nausea, vomiting and weight loss.

Some cryptosporidia are resistant to the chlorine used to eradicate bacteria, parasites, viruses and fungi in all types of water sources, from swimming pools to public water systems, but infections are treatable. Patients are usually prescribed antiprotozoal medication, such as nitazoxanide, as well as fluid replacement. People with healthy immune systems typically get better within two weeks. Those with compromised immune systems are at the most risk of infection and complications.

6. Cyclospora

Credit: M G/Flickr

Consuming fresh produce and plenty of water is normally part of a healthy diet. But even this undeniably good-for-you habit isn't without risk. Your favourite plant to eat could have bacteria hitching a ride. Love a fresh summer salad with a side of contamination? Fresh basil, lettuce and imported raspberries have all been associated with cyclospora outbreaks. In 2014, cyclospora-contaminated cilantro imported from Mexico caused 126 people to fall ill in Texas [source: Food Safety News]. In July 2015, the Department of Social and Health Services (DSHS) had already accounted for 182 cyclospora infections in Texas alone [source: Waller].

Cyclospora is caused by a single-celled parasite, Cyclospora cayetanensis, which infects the small intestine. And that tiny little salad interloper is responsible for some major human misery: frequent watery, explosive diarrhoea. While most cyclospora infections are self-limiting and clear without treatment within a few days to a few months, some may require treatment with sulfonamide antibiotics. Of course, rehydration is a key part of recovery.

5. Cysticercosis

Credit: Roberto J. Galindo/Wikimedia Commons

Some people believe that ingesting a tapeworm will help with weight loss; one Iowa resident, who remains unidentified, ordered a tapeworm on the Internet and swallowed it as her diet strategy.

Tapeworm infections most commonly don't happen because you've eaten a tapeworm, though. Three species are responsible for human infections: Taenia saginata (beef tapeworm), Taenia solium (pork tapeworm) and Taenia asiatica (Asian tapeworm). Infections happen after cysticerci, the larval form of the parasite, are consumed accidentally while eating undercooked or raw beef or pork from a tapeworm-infected animal.

Tapeworms may cause gastrointestinal problems such as abdominal pain and upset stomach, as well as appetite changes and weight loss. For many, the infection is confirmed when tapeworm segments are visible in bowel movements - the stuff of nightmares. But it's Taenia solium [pictured above] that's associated with a more severe form of foodborne illness, cysticerosis. Cysticerosis causes focal neurologic deficit symptoms, headaches and visual disturbances, as well as localized striated muscle nodules and pain. More than 50 million people are infected with cycticerosis, making this tapeworm infection the most common parasitic infection around the world. Neurocysticerosis, when the tapeworm affects the neurological system, is the most common brain infection - plus it's the leading cause of adult-onset seizures [source: Kraft].

It takes two months for the cysticerci, the larval tapeworm, to develop into adulthood. Adult tapeworms may live in the small bowel of a human body for years. Taenia solium, for instance, may grow between 6.5 to 23 feet (2 to 7 meters) long, with as many as 1,000 segments, called proglottids, each containing 50,000 eggs within [source: Pearson].

4. Diphyllobothriasis

Credit: 커뷰/Wikimedia Commons

Not all foodborne illnesses make you wish you were dead because of the symptoms they cause; some feel queasy at the idea of a 30-foot (about 9 meters) long tapeworm living and breeding in their small intestine [source: WebMD].

Diphyllobothrium infection is caused by a parasitic flatworm called Diphyllobothrium latum [pictured above]. It's the largest tapeworm known to infect humans; the infection is acquired after consuming certain undercooked or raw fish, generally freshwater fish such as salmon and trout. Pickled and salted fish may also contain Diphyllobothrium larvae [source: Linklater].

Adults can grow larger than 44 feet (more than 10 meters) long in the small intestine, which is, itself, just 20 feet (6 meters) long and about an inch (2.5 centimetres) in diameter. Despite the size of the tapeworm, most diphyllobothrium infections don't cause any noticeable signs or symptoms, or none more severe than stomach pain and indigestion. But depending where the tapeworm is located and where its segments grow, diphyllobothrium infections may cause intestinal obstruction or gall bladder disease.

3. Haverhill Fever

Credit: Rebecca Lai/Flickr

While it's commonly transmitted through a bite or scratch from an infected rodent, rat-bite fever (RBF) may also be caused by consuming contaminated food or water. When RBF is a foodborne illness, it's called Haverhill fever, and it causes fever, headache, joint and muscle pain and rash, just like RBF. But in addition to all that, the foodborne version also causes severe gastrointestinal distress and pharyngitis.

RBF, and by association Haverhill fever, is a bacterial infection that can be caused by two different bacteria depending where in the world you live: The Streptobacillus moniliformis bacterium is responsible for streptobacillary RBF infections in North America, while Spirillum minus causes spirillary RBF (also known as sodoku), primarily in Asia.

Haverhill fever is caused by consuming food, milk or water that's been in contact with infected rodents - specifically, sorry to say, food contaminated with Streptobacillus moniliformis bacterium through rat faeces or urine. Consider that just one rat may have between 20 and 50 droppings and about a half an ounce (14 millilitres) of urine every day, and then consider what that looks like after 6 litters of rats have infested the space [source: Chamberlain]. It's easy to see how even a small rat problem can cause a lot of contamination.

2. Vibriosis

Credit: Tim Evanson/Flickr

Next time you order oysters on the half shell and are splashing lemon on the first bite, try not to think of this: The bacterium Vibrio vulnificus is abundant in warm coastal waters where oysters feed.

Vibrio vulnificus can infect humans either through an open wound or through the ingestion of contaminated food, typically oysters and other shellfish. Between 1988 and 2006, the Centres for Disease Control and Prevention (CDC) reported more than 900 infections in the Gulf Coast states of Alabama, Florida, Louisiana, Texas and Mississippi. Between 2005 and 2009, 138 people were infected with Vibrio vulnificus in Florida alone, with a significant percent of the foodborne infections caused by contaminated oysters [sources: CDC, Genuardi]

Vibrio vulnificus is in the same family as Vibrio cholerae, the microorganism that causes cholera. That naturally sounds terrifying because cholera is an infamous infectious disease. Vibrio vulnificus, though, causes vibriosis, and symptoms include chills, diarrhoea, fever, nausea, vomiting, skin lesions and, in some instances, shock. Vibrio vulnificus bacterium also is known to cause necrotizing fasciitis, better known as flesh-eating disease.

Maybe instead of going raw, consider ordering the oysters Rockefeller; cooked oysters don't pose a Vibrio vulnificus risk.

1. Shellfish Poisoning

Credit: Breville USA/Flickr

You may have heard the advice, "Never eat seafood in months that don't have the letter R." That's May through August, and because toxic algae blooms occur more frequently during warm months, that may really be good advice.

There are four ways shellfish - seafood with two shells, including clams, mussels and oysters - can make your vacation miserable: amnesic shellfish poisoning (ASP), diarrheal shellfish poisoning (DSP), neurotoxic shellfish poisoning (NSP) and paralytic shellfish poisoning (PSP).

Each type of shellfish poisoning is caused by a different toxin. ASP is caused by domoic acid, produced by Pseudo-nitzschia spp (species pluralis, indicating multiple species with one group). DSP is caused by okadaic acid, produced by Dinophysis spp. The neurotoxin brevetoxin is known to cause NSP and is also associated with the "red tide" (red-hued toxic algal blooms) phenomenon.

There are 20 toxins responsible for paralytic shellfish poisonings (PSP), and all 20 are derivatives of saxitoxin (STX), a toxin produced by the algae bloom Alexandrium fundyense.

Shellfish are filter feeders, which means they eat by filtering microscopic particles from the water. And they don't know the difference between plankton and toxic algae. The toxins accumulate in the body of the clam, mussel, or oyster, and your body absorbs them when you eat the contaminated shellfish, causing gastrointestinal and neurological symptoms.

Author's Note: During my discovery and research process, I read that despite the costs foodborne illnesses pose to public health and safety (the 48 million Americans who get food poisoning each year take a toll on the annual healthcare costs for all Americans, costing an estimated US$15 billion), local health departments are eliminating, or significantly cutting back on food safety programs. For instance, in 2011, 10 percent of local health departments cut or killed their programs because of lack of funding.

Related Articles:

More Great Links:

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Top image: Colour-enhanced scanning electron micrograph showing Salmonella Typhimurium (red) invading cultured human cells. Credit: Rocky Mountain Laboratories, NIAID, NIH/Wikimedia Commons.

[Post Source: How Stuff Works. Edited. Some images added.]

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