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Foodborne Illness

Foodborne illness (commonly known as food poisoning) is a disease caused by consuming contaminated food or drink. There are more than 250 known foodborne illnesses. The majority are infections caused by bacteria, viruses or parasites. Other foodborne illnesses are caused by toxins entering the body after consuming contaminated food.

A foodborne illness outbreak is defined as an incident in which two or more persons from separate households experience a similar illness resulting from the ingestion of a common food or drink. Outbreak investigations of foodborne illness may involve an onsite investigation referred to as an environmental assessment.

Pathogen Information

Common symptoms of foodborne illness are diarrhea and/or vomiting, typically lasting 1 to 7 days. Other symptoms might include abdominal cramps, nausea, fever, body aches and fatigue.

What some people call the “stomach flu” may actually be a foodborne illness and is not related to influenza. The incubation period (the time between exposure to the pathogen and the onset of symptoms) can range from several hours to 1 week or more.

  • Campylobacteriosis (Campylobacter)

    Campylobacteriosis is an infection caused by bacteria of the genus Campylobacter. These bacteria live in many different animals. Campylobacter is one of the most common bacterial causes of diarrheal illness in the United States and the most commonly reported bacterial enteric pathogen in Indiana.

    DISEASE

    PATHOGEN

    INCUBATION PERIOD/MEAN

    DURATION OF ILLNESS

    SYMPTOMS

    FOODS IMPLICATED

    TYPE OF ILLNESS

    RESERVOIR

    Campylobacter

    Campylobacter
    jejuni BACTERIA

    2-5 days

    5-7 days
    3-5 days

    Diarrhea which may be watery or bloody, fever, nausea, headache

    Chicken, unpasteurized milk, water

    Infection

    Domestic and wild animals (intestinal tract)

  • Cryptosporidiosis (Cryptosporidium)

    Cryptosporidium is passed in the stool of an infected person or animal. It is a parasite that can survive outside of the body for long periods of time and is highly resistant to chlorine. You can become infected after accidentally consuming food or water contaminated with oocysts.

  • Cyclosporiasis (Cyclospora spp.)

    Cyclosporiasis is a diarrheal illness caused by the parasite, Cyclospora cayetanensis. People become infected with Cyclospora by consuming food or water that has been contaminated with feces containing the parasite.

  • Escherichia coli O157:H7 (E. coli O157) and Hemolytic Uremic Syndrome (HUS)

    E. coli is a bacteria that normally lives in the intestines of healthy people and animals. There are more than 700 serotypes of E. coli. Most varieties are harmless but some can make you sick with diarrhea, stomach cramps, vomiting and fever.

    PATHOGEN

    INCUBATION PERIOD/MEAN

    DURATION OF ILLNESS

    SYMPTOMS

    FOODS IMPLICATED

    TYPE OF ILLNESS

    RESERVOIR

    Escherichia
    coliBACTERIA

    2-5 days

    5-10 days
    2-5 days

    Diarrhea (may be bloody), abdominal pain, nausea, vomiting, fever, HUS

    Undercooked ground beef, imported cheeses, unpasteurized milk or juice, cider, alfalfa sprouts

    Infection/
    Intoxication

    Human intestinal tract, animals (especially cattle)

  • Giardiasis (Giardia)

    Giardiasis is a parasite that lives in the intestine of people and animals. You can become infected after accidentally ingesting the parasite from contact with contaminated soil, food, water, surfaces, and people sick with giardia.

  • Listeriosis (Listeria monocytogenes)

    Listeriosis is a serious bacterial infection caused by eating food contaminated with Listeria. The illness primarily affects pregnant women and their newborns, older adults, and adults with weakened immune systems.

    DISEASE

    PATHOGEN

    INCUBATION PERIOD/MEAN

    DURATION OF ILLNESS

    SYMPTOMS

    FOODS IMPLICATED

    TYPE OF ILLNESS

    RESERVOIR

    Listeriosis

    Listeria
    monocytogenes
    BACTERIA

    2 days – 3 weeks
    4-21 days

    Indefinite; high fatality in the immuno-compromised

    Nausea, vomiting, chills, headache, fever, backache, meningitis

    Unpasteurized dairy foods, vegetables, meat, poultry, seafood, raw and smoked fish, ready-to-eat foods

    Infection

    Domestic and wild animals, humans, soil

  • Norovirus (stomach flu, gastroenteritis)

    Noroviruses are a group of viruses called caliciviruses. They are often referred to as “the stomach flu” or “food poisoning”.  Norovirus is highly contagious and causes severe vomiting and diarrhea. Anyone can get infected by having direct contact with an infected person, consuming contaminated food or water, or touching contaminated surfaces and putting unwashed hands in your mouth.

    DISEASE

    PATHOGEN

    INCUBATION PERIOD/MEAN

    DURATION OF ILLNESS

    SYMPTOMS

    FOODS IMPLICATED

    TYPE OF ILLNESS

    RESERVOIR

    Norovirus infection

    Noro Virus

    12-96 hours

    1-2 days

    Low-grade fever, chills, headache, muscle ache, and fatigue

    Ready-to-eat foods (salad, sandwiches, bread) shellfish

    Infection

    Human intestinal tract

  • Salmonellosis (Salmonella)

    Salmonellosis is an infection with a bacteria called Salmonella. Salmonella lives in the intestinal tracts of animals. Salmonella can be transmitted to humans by eating foods contaminated with animal feces or touching infected animals, their feces, or their environment.

    DISEASE

    PATHOGEN

    INCUBATION PERIOD/MEAN

    DURATION OF ILLNESS

    SYMPTOMS

    FOODS IMPLICATED

    TYPE OF ILLNESS

    RESERVOIR

    Salmonellosis

    Salmonella
    (facultative)
    BACTERIA

    8-72 hours
    18-36 hours

    2-3 days

    Abdominal pain, headache, fever, nausea, diarrhea, chills, cramps

    Poultry, eggs, meat, meat products, milk, smoked fish, protein foods, juice

    Infection

    Domestic and wild animals, humans

  • Scombroid Fish Poisoning

    Scombroid fish poisoning, or histamine fish poisoning, is a syndrome resembling an allergic reaction that occurs after eating fish contaminated with high levels of histamine. The most common fish with this illness include the Scombridae family (tuna, mackerel, skipjack, and bonito) as well as mahi mahi, bluefish, marlin and escolar. The histamine forms when these fish are not kept properly refrigerated.

  • Shigellosis (Shigella)

    Shigellosis is an infectious disease caused by a group of bacteria called Shigella. The Shigella bacteria pass from one infected person to the next. Shigella are present in the stools of infected persons while they are sick. Transmission occurs when basic hygiene and handwashing habits are not practiced, toddlers are not fully toilet trained, family members of sick children are infected, and swimming in and drinking contaminated water.

    DISEASE

    PATHOGEN

    INCUBATION PERIOD/MEAN

    DURATION OF ILLNESS

    SYMPTOMS

    FOODS IMPLICATED

    TYPE OF ILLNESS

    RESERVOIR

    Shigellosis

    Shigella
    (facultative)
    BACTERIA

    1-7 days
    1-3 days

    Indefinite

    Diarrhea, fever, chills, cramps, lassitude, nausea, dehydration

    Moist, mixed foods, milk, potato, tuna, bean, and macaroni salads, apple cider

    Infection

    Human feces, flies

  • Toxoplasmosis (Toxoplasma gondii)

    Toxoplasmosis is an infection by a parasite called Toxoplasma gondii. The parasite is found everywhere in the environment. Certain people are more likely to have serious illness due to toxoplasmosis. Cats are important in the transmission of toxoplasmosis because of people handling their feces. People can also get toxoplasmosis by eating or handling raw or undercooked pork, lamb or venison, eating unwashed fruits and vegetables grown in soil contaminated with cat feces or drinking contaminated water.

  • Vibrio infection (Vibriosis)

    Vibriosis is an infection with a bacteria in the Vibrio family. People are exposed to Vibrio by consuming raw or undercooked seafood or exposing a wound to seawater. Most infections are seasonal and occur in the summertime when water temperatures are warmer.

  • Yersiniosis (Yersinia species)

    Yersiniosis is an infectious disease caused most often by the Yersinia entercolitica bacteria. Yersiniosis most often occurs in young children and mimics the symptoms of appendicitis. Yersiniosis can be transmitted by eating contaminated food, especially raw or undercooked pork products. Care must be taken while preparing foods such as raw pork intestines (chitterlings) to prevent contaminating foods, surfaces, toys, and bottles. The bacteria can also be transmitted through the stool of an infected person.

Environmental Assessments

Environmental assessments (EAs) are an important part of foodborne illness outbreaks and responses. Food safety programs can use environmental assessments to stop the transmission of an outbreak as well as prevent future outbreaks from occurring.

An EA is a detailed and focused visit to a food establishment in response to illness. Typically, the pathogen and food item of focus are known before the visit. An EA differs from a routine restaurant inspection in that the EA is focused and the routine inspection is broad. The EA looks for clues to determine the contributing factors and environmental antecedents of the outbreak.

IDOH Environmental Assessment Guidance Documents

National Environmental Assessment Reporting System (NEARS)

NEARS is a CDC surveillance system to capture EA data. This data is analyzed and used to improve food safety programs and foodborne illness response.

CDC Environmental Assessments Training

Outbreak Investigations

A foodborne illness outbreak is defined as an incident in which two or more persons from separate households experience a similar illness resulting from the ingestion of a common food or drink. There are typically three parts to a foodborne illness outbreak response: environmental health, epidemiology, and laboratory. Environmental health focuses on the food item and how it was prepared. Epidemiology focuses on the people and collecting their interview data. The laboratory focuses on testing stool, food, and environmental samples. All three partners play an equally important role in confirming the cause of an outbreak.

The Indiana Department of Health works closely with our local health departments in investigating outbreaks. They may visit the food establishment to watch food preparation practices, collect food and environmental samples, and/or collect invoice information for tracebacks. Local health departments may also interview cases (ill people) and complainants to gather more information about their illness as well as collect stool samples.

File a complaint of foodborne illness.


Food Safety Basics

There are four basic steps to food safety: clean, separate, cook and chill. Use these tips to keep you and your loved ones healthy. Other helpful tips include: washing your hands, not washing raw meat in the sink before cooking it, washing produce before eating, not thawing food on the counter, and promptly refrigerating uneaten food after a meal.