Foodborne illnesses

Foodborne Illnesses (Bacterial)
Etiology | Incubation Period | Signs and Symptoms | Duration of Illness | Associated Foods | Laboratory Testing | Treatment |
Bacillus anthracis | 2 days to weeks | Nausea, vomiting, malaise, bloody diarrhea, acute abdominal pain. | Weeks | Insufficiently cooked contaminated meat. | Blood. | Penicillin is first choice for naturally acquired gastrointestinalanthrax. Ciprofloxacin is second option. |
Bacillus cereus (preformed enterotoxin) | 1 to 6 hours | Sudden onset of severe nausea and vomiting. Diarrhea may be present. | 24 hours | Improperly refrigerated cooked and fried rice, meats. | Normally a clinical diagnosis. Clinical laboratories do not routinely identify this organism. If indicated, send stool and food specimens to reference laboratoryfor culture and toxin identification. | Supportive care. |
Bacillus cereus (diarrheal toxin) | 10 to 16 hours | Abdominal cramps, watery diarrhea, nausea. | 24 to 48 hours | Meats, stews, gravies, vanilla sauce. | Testing not necessary, self-limiting (consider testing food and stool for toxin in outbreaks). | Supportive care |
Brucella abortus, Brucella melitensis, and Brucella suis | 7 to 21days | Fever, chills, sweating, weakness, headache, muscle and joint pain, diarrhea, bloody stools during acute phase. | Weeks | Raw milk, goat cheese made from unpasteurized milk, contaminated meats. | Blood culture and positive serology. | Acute: Rifampin and doxycycline daily for >6 weeks. Infections with complications require combination therapy with rifampin, tetracycline and anaminoglycoside. |
Campylobacter jejuni | 2 to 5 days | Diarrhea, cramps, fever, and vomiting; diarrhea may be bloody. | 2 to 10 days | Raw and undercooked poultry, unpasteurized milk, contaminated water. | Routine stool culture; Campylobacter requires special media and incubation at 42 degrees C to grow. | Supportive care. For severe cases, antibiotics such as erythromycin and quinolones may be indicatedearly in the diarrheal disease. Guillain-Barré syndrome can be a sequelae. |
Clostridium botulinum-children and adults (preformed toxin) | 12 to 72 hours | Vomiting, diarrhea, blurred vision, diplopia, dysphagia, and descending muscle weakness. | Variable (from days to months). Can be complicated by respiratory failure and death. | Home-canned foods with a low acid content, improperly cannedcommercial foods, home-canned or fermented fish, herb-infused oils, baked potatoes in aluminum foil, cheese sauce, bottled garlic, foods held warm for extended periods of time (e.g. in a warm oven). | Stool, serum, and food can be tested for toxin. Stool and food can also be cultured for the organism. These tests can be performed at some state health department laboratories and the Centers for DiseaseControl and Prevention (CDC). | Supportive care. Botulinum antitoxin is helpful if given early in the course of the illness. |
Clostridium botulinum-infants | 3 to 30 days | In infants <12 months, lethargy, weakness, poor feeding, constipation, hypotonia, poor head control, poor gag and sucking reflex. | Variable | Honey, home-canned vegetables and fruits, corn syrup. | Stool, serum, andfood can be tested for toxin. Stool and food can also be cultured for the organism. These tests can be performed at some state health department laboratories and the CDC. | Supportive care. Botulism immune globulin can be obtained from the Infant Botulism Prevention Program, Health and Human Services, California. Botulinum antitoxin is generally not recommended for infants. |
Clostridiumperfringens toxin | 8 to 16 hours | Watery diarrhea, nausea, abdominal cramps; fever is rare. | 24 to 48 hours | Meats, poultry, gravy, dried or precooked foods, time- and/or temperature-abused food. | Stools can be tested for enterotoxin and cultured for organism. Because Clostridium perfringens can normally be found in stool, quantitative cultures must be done. | Supportive care. Antibiotics not...