Preventing Foodborne Illness

Food quality control expert inspecting groceries in the laboratory

Since 2019, World Food Safety Day is celebrated each year on the 7th of June,  to promote awareness regarding the need to develop and maintain food safety standards. These efforts are being done both to reduce the burden of foodborne disease and to minimize its impact on socio-economic systems.

Foodborne diseases constitute a major health issue worldwide. The World Health Organization (WHO) estimates that approximately 10% of the global population is infected by foodborne pathogens each year (1). Similar to other diseases, the severity of the foodborne illness varies with the type and the amount of exposure to the causative microorganism or germs, as well as the disease-fighting potential of the affected individual.

Clinical Presentation of Foodborne Diseases

Foodborne illnesses might manifest as acute diarrhea, nausea, etc., which usually resolves within 7 to 10 days; or as chronic and potentially fatal diseases such as botulism or typhoid fever.

Botulism, a common and potentially fatal disease, is caused by Clostridium botulinum. Signs and symptoms usually appear within 18 to 36 hours of food ingestion Bacterial toxins can persist in the patient’s blood for up to 12 days. Common findings include respiratory failure and neurological symptoms, such as blurred vision, paralysis, etc. (2). 

Foodborne cases of botulism in the United States 1979-2019

Prevention and Management of Foodborne Illnesses

Contamination of food or food products can occur at various stages of production, including growth, processing, transportation, or storage. Thus, there is a critical need to adopt appropriate measures that correspond to these variable conditions to maximize food safety and minimize the transmission of foodborne illnesses.

1.     Decontamination of Fresh Produce

With rapid globalization, fresh produce is now available worldwide throughout the year in the form of frozen food.  Fresh produce must undergo proper decontamination before being frozen – to prevent such diseases as norovirus infection and hepatitis A (3, 4). Some of the common techniques used for decontamination include (5):

a.     Application of antibiotics during the growth stage

b.     Proactive sampling for detection of pathogens

c.     Bacteriocins (bacteria-generated toxins to kill the competitive strains)

d.     Antimicrobial natural products and nanoparticles

e.     Bacteriophages

f.      Irradiation 

Alternatively, consumers might receive probiotics and relevant vaccines to protect them from relevant foodborne illnesses.

2.     Development of Public Health Surveillance Systems

A competent public health surveillance system should be implemented by the governmental and related organizations to identify impending outbreaks in order to facilitate effective policies and goals (6, 7). Such systems help control and prevent extensive transmission by collecting and analyzing epidemiological and clinical data that provide guidelines to take appropriate measures.

3.     Prophylactic Measures for People with Increased Susceptibility to These Illnesses

People who are vulnerable to foodborne infections, such as older adults, infants – and individuals with prior diseases of the immune system, liver, gastrointestinal tract, etc. should be particularly vigilant and observe preventive measures (8) including: 

a.   Adherence to a low-microbial diet and avoidance of undercooked meat, unpasteurized milk, etc.

b.  Consumption of  bottled natural water

c.   Infants should be preferably given sterile ready-to-eat formula; powdered formula should be reconstituted in boiling water and given in boiled water-  sterilized bottles

d.  Antimicrobial may be administered prophylactically during transplantation and other high-risk treatments.

4.     Food Safety Measures for Health

In general, people should adopt safe food practices wherever they cook and consume food or food products (9). The cooking utensils/surfaces should be properly cleaned and sanitized. Raw and undercooked foods should be stored separately to avoid cross-contamination. Food should be cooked or reheated thoroughly, meats and seafood should be cooked to appropriate temperatures. Cooked food should be stored at < 5°C, and not for prolonged periods. Only clean, purified water should be used for cooking food to minimize any chances of waterborne infection. Raw fruits and vegetables should be properly washed before consumption.

Raw fruits and vegetables should be properly washed before consumption.

At the Public Health level, comprehensive integration of government-issued guidelines and self-monitoring are needed to prevent and control foodborne illnesses.

References

1.     “Foodborne diseases”, World Health Organization. [Online]
2.     “Botulism”, GIDEON Informatics, Inc, 2021 [Online]
3.     Nasheri N, Vester A, Petronella N. Foodborne viral outbreaks associated with frozen produce. Epidemiol Infect. 2019 Oct;147:e291. doi: 10.1017/S0950268819001791.
4.     Chapman B, Gunter C. Local Food Systems Food Safety Concerns. Microbiol Spectr. 2018 Apr; 6(2). doi: 10.1128/microbiolspec.PFS-0020-2017.
5.     Yang SC, Lin CH, Aljuffali IA, Fang V. Current pathogenic Escherichia coli foodborne outbreak cases and therapy development. Arch. Microbiol. 2017 June; 199(6): 811-825. doi.org/10.1007/s00203-017-1393-y.
6.     Ward H, Molesworth A, Holmes S, Sinka K. Public health: surveillance, infection prevention, and control. Handb Clin Neurol. 2018; 153:473-484. doi: 10.1016/B978-0-444-63945-5.00027-1.
7.     Hoelzer K, Moreno Switt AI, Wiedmann M, Boor KJ. Emerging needs and opportunities in foodborne disease detection and prevention: From tools to people. Food Microbiol. 2018 Oct; 75:65-71. doi: 10.1016/j.fm.2017.07.006.
8.     Lund BM, O’Brien SJ. The occurrence and prevention of foodborne disease in vulnerable people. Foodborne Pathog Dis. 2011 Sep; 8(9):961-73. doi: 10.1089/fpd.2011.0860.
9.     “Five keys to safer food manual”, World Health Organization [Online]