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| {{DiseaseDisorder infobox |
| | __NOTOC__ |
| Nawe = Foodborne illness |
| | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| Image = |
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| Caption = |
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| ICD10 = |
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| ICD9 = {{ICD9|005.9}} |
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| ICDO = |
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| OMIM = |
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| DiseasesDB = 31112 |
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| MedlinePlus = |
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| eMedicineSubj = med |
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| eMedicineTopic = 807 |
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| }}
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| {{SI}}
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| {{CMG}} | | {{Foodborne illness}} |
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| {{EH}} | | {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} |
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| ==Overview==
| | {{SK}} Food poisoning |
| '''foodborne illness''' (also '''foodborne disease''') is any [[illness]] resulting from the consumption of food. Although foodborne illness is commonly called '''food poisoning''', this is often a misnomer. True food poisoning occurs when a person ingests a contaminating chemical or a natural [[toxin]], while most cases of foodborne illness are actually '''food infection''' caused by a variety of foodborne [[pathogen]]ic [[bacterium|bacteria]], [[virus]]es, [[prion]]s or [[parasite]]s.<ref>[http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm US CDC food poisoning guide]</ref> Such contamination usually arises from improper handling, preparation, or [[food storage]]. Good [[hygiene]] practices before, during, and after food preparation can reduce the chances of contracting an illness. The action of monitoring food to ensure that it will not cause foodborne illness is known as '''[[food safety]]'''. Foodborne disease can also be caused by a large variety of toxins that affect the environment. For foodborne illness caused by chemicals, see [[Food contaminants]].
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| Foodborne illness can also be caused by the presence of [[pesticide]]s or [[medicine]]s in food, or by unintentionally consuming naturally toxic substances like [[mushroom poisoning|poisonous mushroom]]s or [[tetrodotoxin|reef fish]]. | | ==[[Foodborne illness overview|Overview]]== |
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| ==Symptoms and mortality== | | ==[[Foodborne illness historical perspective|Historical Perspective]]== |
| [[Symptom]]s typically begin several hours to several days after [[eating|ingestion]] and depending on the agent involved, can include one or more of the following: [[nausea]], [[abdominal pain]], [[vomiting]], [[diarrhea]], [[gastroenteritis]], [[pyrexia|fever]], [[headache]] or [[fatigue (physical)|fatigue]]. In most cases the body is able to permanently recover after a short period of [[Acute (medical)|acute]] discomfort and illness. However, foodborne illness can result in permanent health problems or even death, especially in [[baby|babies]], [[pregnant]] [[women]] (and their [[fetus]]es), [[elderly]] people, [[sick]] people and others with weak [[immune system]]s. Foodborne illness is a major cause of [[reactive arthritis]], which typically occurs 1–3 weeks afterward. Similarly, people with [[liver]] disease are especially susceptible to infections from [[Vibrio vulnificus]], which can be found in [[oyster]]s or crabs. Typically food poisoning is evident when uncooked, or unprepared food is eaten. | |
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| The symptoms of [[Creutzfeldt-Jacob disease]], transmitted usually by eating beef from animals with [[bovine spongiform encephalopathy]] (BSE, mad cow disease), are different from bacterial food poisoning and only appear after many years; the disease is [[fatal]] after symptoms appear.
| | ==[[Foodborne illness classification|Classification]]== |
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| [[Tetrodotoxin]] poisoning from reef fish and other animals manifests rapidly as [[numbness]] and [[shortness of breath]], and is often fatal. | | ==[[Foodborne illness pathophysiology|Pathophysiology]]== |
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| ==Incubation period== | | ==[[Foodborne illness causes|Causes]]== |
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| The delay between consumption of a contaminated food and appearance of the first [[symptom]]s of illness is called the [[incubation period]]. This ranges from hours to days (and rarely months or even years, such as in the case of [[Listeriosis]] or [[Creutzfeldt-Jacob disease]]), depending on the agent, and on how much was consumed. If symptoms occur within 1–6 hours after eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than live bacteria.
| | ==[[Foodborne illness differential diagnosis|Differentiating Foodborne Illness from other Diseases]]== |
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| During the incubation period, [[microbe]]s pass through the [[stomach]] into the [[intestine]], attach to the [[cell (biology)|cell]]s lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a [[toxin]] that is absorbed into the [[blood]]stream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe. [http://www.cdc.gov/ncidod/dbmd/outbreak/guide_fd.htm]
| | ==[[Foodborne illness epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Infectious dose== | | ==[[Foodborne illness risk factors|Risk Factors]]== |
| The infectious dose is the amount of agent that must be consumed to give rise to symptoms of foodborne illness, and varies according to the agent and the consumer's age and overall health. In the case of [[Salmonella]] a relatively large inoculum of 1 million to 1 billion organisms is necessary to produce symptoms in healthy human volunteers[http://www.emedicine.com/emerg/topic515.htm], as Salmonellae are very sensitive to acid. An unusually high stomach pH level (low acidity) greatly reduces the number of bacteria required to cause symptoms by a factor of between 10 and 100.
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| ==Pathogenic agents== | | ==[[Foodborne illness natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| {{see also|Pathogen}}
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| ===Bacteria===
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| [[Bacteria]] are a common cause of foodborne illness. In the United Kingdom during 2000 the individual bacteria involved were as follows: ''[[Campylobacter jejuni]]'' 77.3%, ''[[Salmonella]]'' 20.9%, ''[[Escherichia coli O157:H7]]'' 1.4%, and all others less than 0.1%<ref> [http://www.food.gov.uk/science/sciencetopics/microbiology/58736 Food Standards Agency]</ref> . In the past, bacterial infections were thought to be more prevalent because few places had the capability to test for [[norovirus]] and no active surveillance was being done for this particular organism. Symptoms for bacterial infections are delayed because the bacteria need time to multiply. They are usually not seen until 12–72 hours or more after eating contaminated food. | |
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| '''Most common''' bacterial foodborne pathogens are:
| | ==Diagnosis== |
| *''[[Campylobacter|Campylobacter jejuni]]'' which can lead to secondary [[Guillain-Barré syndrome]] and [[periodontitis]] <ref name=cazp>{{cite journal
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| | last = Humphrey
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| | first = Tom ''et al.''
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| | authorlink =
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| | coauthors =
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| | title = Campylobacters as zoonotic pathogens: A food production perspective <internet>
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| | journal = International Journal of Food Microbiology
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| | volume = 117
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| | issue = 3
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| | publisher =
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| | doi = 10.1016
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| | date = 2007
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| | url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4N0PPRG-1&_user=10&_coverDate=07%2F15%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=74b7c07635a1873ca815b3139b56d2e0}}</ref>
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| *''[[Salmonella]]'' spp. - its ''S. Typhimurium'' infection is caused by consumption of eggs that are not adequately cooked or by other interactive human-animal pathogens <ref name=aoostpt>{{cite web
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| | last = Tribe
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| | first = Ingrid G. ''et al.''
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| | authorlink =
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| | coauthors =
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| | title = An outbreak of Salmonella Typhimurium phage type 135 infection linked to the consumption of raw shell eggs in an aged care facility <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/cda-pubs-cdi-2002-cdi2601-cdi2601h.htm}}</ref><sup>,</sup> <ref name=sisaa>{{cite web
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| | last = Centers for Disease Control and Prevention
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Salmonella Infection (salmonellosis) and Animals <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.cdc.gov/healthypets/diseases/salmonellosis.htm}}</ref><sup>,</sup> <ref name=rcfp>{{cite web
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| | last = Doyle
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| | first = M. P.
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| | authorlink =
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| | coauthors = M. C. Erickson
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| | title = Reducing the carriage of foodborne pathogens in livestock and poultry <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.poultryscience.org/ps/paperpdfs/06/p0660960.pdf}}</ref>.
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| *''[[Escherichia coli O157:H7]]'' enterohemorrhagic (EHEC) which causes [[hemolytic-uremic syndrome]]
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| Other '''common''' bacterial foodborne pathogens are:
| | [[Foodborne illness history and symptoms|History and Symptoms]] | [[Foodborne illness physical examination|Physical Examination]] | [[Foodborne illness laboratory findings|Laboratory Findings]] | [[Foodborne illness other diagnostic studies|Other Diagnostic Studies]] |
| *''[[Bacillus cereus]]''
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| *''[[Escherichia coli]]'', other [[Virulence properties of escherichia coli|virulence properties]], such as enteroinvasive (EIEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroaggregative (EAEC or EAgEC)
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| [[Image:SalmonellaNIAID.jpg|left|200px|thumb|''Salmonella'']] | |
| *''[[Listeria monocytogenes]]''
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| *''[[Shigella]]'' spp.
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| *''[[Staphylococcus aureus]]''
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| *''[[Streptococcus]]''
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| *''[[Vibrio cholerae]]'', including O1 and non-O1
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| *''[[Vibrio parahaemolyticus]]''
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| *''[[Vibrio vulnificus]]''
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| *''[[Yersinia enterocolitica]]'' and ''[[Yersinia pseudotuberculosis]]''
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| '''Less common''' bacterial agents:
| | ==Treatment== |
| *''[[Brucella]]'' spp.
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| *''[[Actinobacteria|Corynebacterium ulcerans]]''
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| *''[[Q fever|Coxiella burnetii]]'' or Q fever
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| *''[[Plesiomonas shigelloides]]''
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| ====Exotoxins====
| | [[Foodborne illness medical therapy|Medical Therapy]] | [[Foodborne illness primary prevention|Primary Prevention]] | [[Foodborne illness secondary prevention|Secondary Prevention]] | [[Foodborne illness cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Foodborne illness future or investigational therapies|Future or Investigational Therapies]] |
| In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by [[exotoxin]]s which are [[excretion|excreted]] by the cell as the bacterium grows. Exotoxins can produce illness even when the microbes that produced them have been killed. Symptoms typically appear after 1–6 hours depending on the amount of toxin ingested.
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| *''[[Clostridium botulinum]]''
| | ==Case Studies== |
| *''[[Clostridium perfringens]]''
| | [[Foodborne illness case study one|Case #1]] |
| *''[[Staphylococcus aureus]]''
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| *''[[Bacillus cereus]]''
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| For example ''[[Staphylococcus aureus]]'' produces a toxin that causes intense [[vomiting]]. The rare but potentially deadly disease [[botulism]] occurs when the [[Anaerobic organism|anaerobic]] bacterium ''[[Clostridium botulinum]]'' grows in improperly canned low-acid foods and produces [[botulin]], a powerful paralytic toxin.
| | ==Related Chapters== |
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| Pseudoalteromonas tetraodonis, certain species of [[Pseudomonas]] and [[Vibrio]], and some other bacteria, produce the lethal [[tetrodotoxin]], which is present in the [[tissue (biology)|tissue]]s of some living animal species rather than being a product of [[decomposition]].
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| === Mycotoxins & alimentary mycotoxicoses === | |
| The term '''alimentary mycotoxicoses''' refers to the effect of poisoning by [[Mycotoxins]] through food consumption. [[Mycotoxins]] have prominently affected on human and animal health such as an outbreak which occurred in the UK in 1960 that caused the death of 100,000 turkeys which had consumed [[aflatoxin]]-contaminated peanut meal and the death of 5000 human lives by Alimentary toxic aleukia (ALA) in the USSR in World War II<ref name=fam>{{cite web
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| | last = E. Mount
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| | first = Michael
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| | authorlink =
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| | coauthors =
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| | title = Fungi and Mycotoxins <internet>
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| | publisher =
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| | accessdaymonth = 11 August
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| | accessyear = 2007
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| | url = http://www.vetmed.ucdavis.edu/PHR/PHR250/2007/25007Myc.pdf}}</ref>. The common foodborne [[Mycotoxins]] include
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| * [[Aflatoxins]] - originated from [[Aspergillus parasiticus]] and [[Aspergillus flavus]]. They are frequently found in tree nuts, peanuts, maize, sorghum and other oilseeds, including corn and cottonseeds. The pronounced forms of [[Aflatoxins]] are those of B1, B2, G1, and G2, amongst which Aflatoxin B1 predominantly targets the liver, which will result in [[necrosis]], [[cirrhosis]], and [[carcinoma]] <ref name=afltx>{{cite web
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| | last = Center for Food Safety & Applied Nutrition
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Aflatoxins <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.cfsan.fda.gov/~mow/chap41.html}}</ref><sup>,</sup> <ref name=gtlmg>{{cite web
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| | last = Food and Agriculture Organization of the United Nations
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = GASGA Technical Leaflet - 3 Mycotoxins in Grain <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.fao.org/Wairdocs/X5008E/X5008e01.htm}}</ref>. In the US, the acceptable level of total aflatoxins in foods is less than 20 μg/kg, except for Aflatoxin M1 in milk, which should be less than 0.5 μg/kg <ref name=cfh>{{cite web
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| | last = World Health Organization
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Chapter 2 Foodborne Hazards in ''Basic Food Safety for Health Workers'' <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.who.int/entity/foodsafety/publications/capacity/en/2.pdf}}</ref>. The official document can be found at [[Food and Drug Administration|FDA]]'s website <ref name=sec683100>{{cite web
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| | last = Food and Drug Administration
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Sec. 683.100 Action Levels for Aflatoxins in Animal Feeds (CPG 7126.33) <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.fda.gov/ora/compliance_ref/cpg/cpgvet/cpg683-100.html}}</ref><sup>,</sup> <ref name=mfcvmp>{{cite web
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| | last = Henry
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| | first = Michael H.
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| | authorlink =
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| | coauthors =
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| | title = Mycotoxins in Feeds: CVM’s Perspective <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.fda.gov/cvm/fdaaustintx823.htm}}</ref>.
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| * Altertoxins - are those of [[Alternariol]] (AOH), [[Alternariol]] methyl ether (AME), Altenuene (ALT), Altertoxin-1 (ATX-1), Tenuazonic acid (TeA) and Radicinin (RAD), originated from [[Alternaria]] spp. Some of the toxins can be present in sorghum, [[Finger millet|ragi]], wheat and tomatoes <ref name=atwdw>{{cite web
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| | last = Webley
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| | first = D. J. ''et al.''
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| | authorlink =
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| | coauthors =
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| | title = Alternaria toxins in weather-damaged wheat and sorghum in the 1995-1996 Australian harvest <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.publish.csiro.au/paper/A97005.htm}}</ref><sup>,</sup> <ref name=amwwc>{{cite web
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| | last = Li
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| | first = Feng-qin
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| | authorlink =
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| | coauthors = Takumi Yoshizawa
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| | title = Alternaria Mycotoxins in Weathered Wheat from China <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://pubs.acs.org/cgi-bin/abstract.cgi/jafcau/2000/48/i07/abs/jf0000171.html}}</ref><sup>,</sup> <ref name=sbtp>{{cite web
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| | last = da Motta
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| | first = Silvana
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| | authorlink =
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| | coauthors = Lucia M. Valente Soares
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| | title = Survey of Brazilian tomato products for alternariol, alternariol monomethyl ether, tenuazonic acid and cyclopiazonic acid <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.informaworld.com/smpp/content~content=a713810863~db=all}}</ref>. Some research has shown that the toxins can be easily cross-contaminated between grain commodities, suggesting that manufacturing and storage of grain commodities is a critical practice <ref name=pamaa>{{cite web
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| | last = Li
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| | first = F. Q. ''et al.''
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| | authorlink =
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| | coauthors =
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| | title = Production of Alternaria Mycotoxins by Alternaria alternata Isolated from Weather-Damaged Wheat <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.ingentaconnect.com/content/iafp/jfp/2001/00000064/00000004/art00025}}</ref>.
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| * [[Citrinin]] -
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| * Citreoviridin -
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| * [[Cyclopiazonic acid]] -
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| * [[Cytochalasins]]
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| * [[Ergot alkaloids]] / [[Ergopeptine]] [[alkaloids]] - [[Ergotamine]]
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| * [[Fumonisins]] - Crop corn can be easily contaminated by the fungi [[Fusarium moniliforme]], and its [[Fumonisin B1]] will cause Leukoencephalomalacia (LEM) in horses, [[Pulmonary edema syndrome]] (PES) in pigs, liver cancer in rats and [[Esophageal cancer]] in humans <ref name=ftihah>{{cite web
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| | last = Marasas
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| | first = Walter F. O.
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| | authorlink =
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| | coauthors =
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| | title = Fumonisins: Their implications for human and animal health <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www3.interscience.wiley.com/cgi-bin/abstract/112640083/ABSTRACT?CRETRY=1&SRETRY=0}}</ref><sup>,</sup> <ref name=off>{{cite web
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| | last = Soriano
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| | first = J.M.
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| | authorlink =
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| | coauthors = S. Dragacci
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| | title = Occurrence of fumonisins in foods <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T6V-4D636PW-1&_user=10&_coverDate=01%2F01%2F2004&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4a033a232e75e4ebf3ee269c06744491}}</ref>. For human and animal health, both the [[Food and Drug Administration|FDA]] and the EC have regulated the content levels of toxins in food and animal feed <ref name=CVMF>{{cite web
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| | last = Food and Drug Administration
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = CVM and Fumonisins <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.fda.gov/cvm/fumonisin.htm}}</ref><sup>,</sup> <ref name=mcmmp>{{cite web
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| | last = Food Standards Agency
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = More contaminated maize meal products withdrawn from sale <internet>
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| | publisher =
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| | accessdaymonth = 12 August
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| | accessyear = 2007
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| | url = http://www.food.gov.uk/news/newsarchive/2003/sep/moremaize}}</ref>.
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| * [[Fusaric acid]] -
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| * Fusarochromanone -
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| * [[Kojic acid]] - ?
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| * Lolitrem alkaloids -
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| * [[Moniliformin]] -
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| * 3-Nitropropionic acid -
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| * Nivalenol -
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| * [[Ochratoxins]] - In Australia, The Limit of Reporting (LOR) level for [[Ochratoxin A]] (OTA) analyses in 20th Australian Total Diet Survey was 1 µg/kg <ref name=2atds>{{cite web
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| | last = Food Standards Australia New Zealand
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = 20th Australian Total Diet Survey - Part B <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.foodstandards.gov.au/newsroom/publications/20thaustraliantotaldietsurveyjanuary2003/20thaustraliantotaldietsurveyfullreport/partb20thatds/partbmetals.cfm}}</ref>, whereas the [[European commission|EC]] restricts the content of OTA to 5 µg/kg in cereal commodities, 3 µg/kg in processed products and 10 µg/kg in dried vine fruits <ref name=wrmff>{{cite web
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| | last = FAO FOOD AND NUTRITION PAPER 81
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Worldwide regulations for mycotoxins in food and feed in 2003 <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.fao.org/docrep/007/y5499e/y5499e0f.htm}}</ref>.
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| * Oosporeine -
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| * [[Patulin]] - Currently, this toxin has been advisably regulated on fruit products. The EC and the [[Food and Drug Administration|FDA]] have limited it to under 50 µg/kg for fruit juice and fruit nectar, while limits of 25 µg/kg for solid-contained fruit products and 10 µg/kg for baby foods were specified by the EC <ref name=wrmff>{{cite web
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| | last = FAO FOOD AND NUTRITION PAPER 81
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Worldwide regulations for mycotoxins in food and feed in 2003 <internet>
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| | publisher =
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| | accessdaymonth = 13 August
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| | accessyear = 2007
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| | url = http://www.fao.org/docrep/007/y5499e/y5499e0f.htm}}</ref><sup>,</sup> <ref name=pajajc>{{cite web
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| | last = Food and Drug Administration
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| | first =
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| | authorlink =
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| | coauthors =
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| | title = Patulin in Apple Juice, Apple Juice Concentrates and Apple Juice Products <internet>
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| | publisher =
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| | accessdaymonth = 16 August
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| | accessyear = 2007
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| | url = http://vm.cfsan.fda.gov/~dms/patubckg.html}}</ref>
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| * [[Phomopsins]] -
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| * Sporidesmin A -
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| * [[Sterigmatocystin]] -
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| * Tremorgenic [[mycotoxins]] - Five of them have been reported to be associated with molds found in fermented meats. These are Fumitremorgen B, [[Paxilline]], [[Penitrem A]], Verrucosidin, and Verruculogen <ref name=gaftm>{{cite web
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| | last = Sabater-Vilar
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| | first = M.
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| | authorlink =
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| | coauthors =
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| | title = Genotoxicity Assessment of Five Tremorgenic Mycotoxins (Fumitremorgen B, Paxilline, Penitrem A, Verruculogen, and Verrucosidin) Produced by Molds Isolated from Fermented Meats <internet>
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| | publisher =
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| | accessdaymonth = 16 August
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| | accessyear = 2007
| |
| | url = http://www.ingentaconnect.com/content/iafp/jfp/2003/00000066/00000011/art00023}}</ref>.
| |
| | |
| * [[Trichothecenes]] - sourced from Cephalosporium, [[Fusarium]], Myrothecium, [[Stachybotrys]] and [[Trichoderma]]. The toxins are usually found in molded maize, wheat, corn, peanuts and rice, or animal feed of hay and straw <ref name=ofst>{{cite web
| |
| | last = Adejumo
| |
| | first = Timothy O.
| |
| | authorlink =
| |
| | coauthors =
| |
| | title = Occurrence of Fusarium species and trichothecenes in Nigerian maize <internet>
| |
| | publisher = Elsevier
| |
| | accessdaymonth = 12 August
| |
| | accessyear = 2007
| |
| | url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4N5CX4H-3&_user=10&_coverDate=05%2F30%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d02d1b28456dfbef669d57692ac28244}}</ref><sup>,</sup> <ref name=snhe>{{cite web
| |
| | last = Mazur
| |
| | first = Lynnette J.
| |
| | authorlink =
| |
| | coauthors = Janice Kim
| |
| | title = Spectrum of Noninfectious Health Effects From Molds <internet>
| |
| | publisher = American Academy of Pediatrics
| |
| | accessdaymonth = 12 August
| |
| | accessyear = 2007
| |
| | url = http://pediatrics.aappublications.org/cgi/content/full/118/6/e1909}}</ref>. Four trichothecenes, T-2 toxin, HT-2 toxin, diacetoxyscirpenol (DAS) and [[deoxynivalenol]] (DON) have been most commonly encountered by humans and animals. The consequences of oral intake of, or dermal exposure to, the toxins will result in Alimentary toxic aleukia, [[neutropenia]], [[aplastic anemia]], [[thrombocytopenia]] and/or skin irritaion <ref name=tthm>{{cite web
| |
| | last = Froquet
| |
| | first = R. ''et al.''
| |
| | authorlink =
| |
| | coauthors =
| |
| | title = Trichothecene toxicity on human megakaryocyte progenitors (CFU-MK) <internet>
| |
| | publisher = SAGE Publications
| |
| | accessdaymonth = 12 August
| |
| | accessyear = 2007
| |
| | url = http://het.sagepub.com/cgi/content/abstract/20/2/84}}</ref><sup>,</sup> <ref name=csytt>{{cite web
| |
| | last = Joffe
| |
| | first = A. Z.
| |
| | authorlink =
| |
| | coauthors = B. Yagen
| |
| | title = Comparative study of the yield of T-2 toxic produced by Fusarium poae, F. sporotrichioides and F. sporotrichioides var. tricinctum strains from different sources <internet>
| |
| | publisher = SAGE Publications
| |
| | accessdaymonth = 12 August
| |
| | accessyear = 2007
| |
| | url = http://het.sagepub.com/cgi/content/abstract/20/2/84}}</ref><sup>,</sup> <ref name=fis>{{cite web
| |
| | last = Hay
| |
| | first = Rod J.
| |
| | authorlink =
| |
| | coauthors = B. Yagen
| |
| | title = Fusarium infections of the skin <internet>
| |
| | publisher =
| |
| | accessdaymonth = 12 August
| |
| | accessyear = 2007
| |
| | url = http://www.co-infectiousdiseases.com/pt/re/coinfdis/abstract.00001432-200704000-00002.htm;jsessionid=G2JGL27MSRdb4TS82LyckCgxLH2zJLX3ynBfjz5kjMyfh4WpVkLg!1152499061!181195629!8091!-1}}</ref>. In 1993, the [[Food and Drug Administration|FDA]] issued a document for the content limits of DON in food and animal feed at an advisory level <ref name=gifda>{{cite web
| |
| | last = Food and Drug Administration
| |
| | first =
| |
| | authorlink =
| |
| | coauthors =
| |
| | title = Guidance for Industry and FDA - Letter to State Agricultural Directors, State Feed Control Officials, and Food, Feed, and Grain Trade Organizations <internet>
| |
| | publisher =
| |
| | accessdaymonth = 13 August
| |
| | accessyear = 2007
| |
| | url = http://www.cfsan.fda.gov/~dms/graingui.html}}</ref>. In 2003, US published a patent that is very promising for farmers to produce a trichothecene-resistant crop <ref name=trtp>{{cite web
| |
| | last = Hohn
| |
| | first = Thomas M.
| |
| | authorlink =
| |
| | coauthors =
| |
| | title = Trichothecene-resistant transgenic plants <internet>
| |
| | publisher =
| |
| | accessdaymonth = 13 August
| |
| | accessyear = 2007
| |
| | url = http://www.patentstorm.us/patents/6646184.html}}</ref>.
| |
| | |
| * [[Zearalenone]] -
| |
| | |
| * Zearalenols -
| |
| | |
| ====Emerging foodborne pathogens====
| |
| Much is still not known about foodborne illness. Approximately sixty percent of outbreaks are still caused by unknown sources.
| |
| | |
| *''[[Aeromonas hydrophila]]'', ''Aeromonas caviae'', ''Aeromonas sobria''
| |
| | |
| ====Preventing bacterial food poisoning====
| |
| Prevention is mainly the role of the state, through the definition of strict rules of [[hygiene]] and a public services of [[veterinary medicine|veterinary]] surveying of animal products in the food chain, from farming to the transformation industry and delivery (shops and restaurants). This regulation includes:
| |
| * [[traceability]]: in a final product, it must be possible to know the origin of the ingredients (originating farm, identification of the harvesting or of the animal) and where and when it was processed; the origin of the illness can thus be tracked and solved (and possibly penalized), and the final products can be removed from the sale if a problem is detected;
| |
| * enforement of hygiene procedures like [[HACCP]] and the "[[cold chain]]";
| |
| * power of control and of law enforcement of [[veterinarian]]s.
| |
| | |
| In August 2006, the United States [[Food and Drug Administration]] approved [[Phage therapy]] which involves spraying meat with viruses that infect bacteria, and thus preventing infection. This has raised concerns, because without [[mandatory labelling]] consumers wouldn't be aware that meat and poultry products have been treated with the spray. [http://www.forbes.com/business/healthcare/feeds/ap/2006/08/18/ap2959720.html]
| |
| | |
| At home, prevention mainly consists of good [[food safety]] practices. Many forms of bacterial poisoning can be prevented even if food is contaminated by heating it sufficiently, and either eating it quickly or refrigerating it effectively. Heating to about 65 degrees Celsius for a few minutes is sufficient. Many toxins, however, are not destroyed by heat treatment.
| |
| | |
| ===Viruses===
| |
| [[Virus|Viral]] infections make up perhaps one third of cases of food poisoning in developed countries. In the US, more than 50% of cases are viral and [[Norwalk virus group|noroviruses]] are the most common foodborne illness, causing 57% of outbreaks in 2004. Foodborne viral infection are usually of intermediate (1–3 days) [[incubation period]], causing illnesses which are self-limited in otherwise healthy individuals, and are similar to the bacterial forms described above.
| |
| [[Image:Rotavirus.jpg|right|200px|thumb|Rotavirus]]
| |
| * [[Enterovirus]]
| |
| * [[Hepatitis A]] is distinguished from other viral causes by its prolonged (2–6 week) [[incubation period]] and its ability to spread beyond the stomach and intestines, into the [[liver]]. It often induces [[jaundice]], or yellowing of the skin, and rarely leads to chronic liver dysfunction. The virus has been found to cause the infection due to the consumption of fresh-cut produce which has fecal contamination <ref name=ivcma>{{cite web
| |
| | last = Dubois
| |
| | first = Eric ''et al.''
| |
| | authorlink =
| |
| | coauthors =
| |
| | title = Intra-laboratory validation of a concentration method adapted for the enumeration of infectious F-specific RNA coliphage, enterovirus, and hepatitis A virus from inoculated leaves of salad vegetables <internet>
| |
| | publisher =
| |
| | accessdaymonth = 11 August
| |
| | accessyear = 2007
| |
| | url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4HYMVXK-4&_user=10&_coverDate=04%2F25%2F2006&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=29d010eafc89179a9a66fd24a4b44e21}}</ref><sup>,</sup> <ref name=imqsf>{{cite web
| |
| | last = Schmidt
| |
| | first = Heather Martin
| |
| | authorlink =
| |
| | coauthors =
| |
| | title = Improving the microbilological quality and safety of fresh-cut tomatoes by low dose dlectron beam irradiation - Master thesis <internet>
| |
| | publisher =
| |
| | accessdaymonth = 11 August
| |
| | accessyear = 2007
| |
| | url = http://txspace.tamu.edu/bitstream/1969.1/2767/1/etd-tamu-2004B-FSTC-Schmidt.pdf}}</ref>.
| |
| * [[Hepatitis E]]
| |
| * [[Norovirus]]
| |
| * [[Rotavirus]]
| |
| | |
| ===Parasites===
| |
| Most foodborne [[parasite]]s are [[zoonosis|zoonoses]].
| |
| | |
| [[Platyhelminthes]]:
| |
| * ''[[Diphyllobothrium]]'' sp.
| |
| [[Image:Tenia solium scolex.jpg|right|200px|thumb|The scolex of ''Tenia solium'']]
| |
| *''[[Nanophyetus]]'' sp.
| |
| *''[[Taenia saginata]]''
| |
| *''[[Taenia solium]]''
| |
| *''[[Fasciola hepatica]]''
| |
| ''See also: [[Tapeworm]] and [[Flatworm]]''
| |
| | |
| [[Nematode]]:
| |
| *''[[Anisakis]]'' sp.
| |
| *''[[Ascaris lumbricoides]]''
| |
| *''[[Eustrongylides]]'' sp.
| |
| *''[[Trichinosis|Trichinella spiralis]]''
| |
| *''[[Trichuris trichiura]]''
| |
| | |
| [[Protozoa]]:
| |
| [[Image:Giardia lamblia.jpg|right|200px|thumb|''Giardia lamblia'']]
| |
| * ''[[Acanthamoeba]]'' and other free-living [[amoeba]]e
| |
| * ''[[Cryptosporidiosis|Cryptosporidium parvum]]''
| |
| * ''[[Cyclospora cayetanensis]]''
| |
| * ''[[Entamoeba histolytica]]''
| |
| * ''[[Giardia lamblia]]''
| |
| * ''[[Sarcocystis hominis]]''
| |
| * ''[[Sarcocystis suihominis]]''
| |
| * ''[[Toxoplasma gondii]]''
| |
| | |
| ===Natural toxins===
| |
| Several foods can naturally contain [[toxins]], many of which are not produced by bacteria. Plants in particular may be toxic; animals which are naturally poisonous to eat are rare. In evolutionary terms, animals can escape being eaten by fleeing; plants can use only passive defences such as poisons and distasteful substances, for example [[capsaicin]] in [[chili]]s and pungent [[sulphur]] compounds in [[garlic]] and [[onion]]s. Most animal poisons are not synthesised by the animal, but acquired by eating poisonous plants to which the animal is immune, or by bacterial action.
| |
| * [[Alkaloid]]s
| |
| * [[Ciguatera poisoning]]
| |
| * [[Grayanotoxin]] ([[honey]] intoxication)
| |
| * [[Mushroom poisoning|Mushroom]] toxins
| |
| * [[Phytohaemagglutinin]] (red [[kidney bean]] poisoning; destroyed by boiling)
| |
| * [[Pyrrolizidine alkaloid]]
| |
| * [[Shellfish toxin]], including [[paralytic shellfish poisoning]], diarrhetic shellfish poisoning, neurotoxic shellfish poisoning, [[domoic acid|amnesic shellfish poisoning]] and [[ciguatera]] fish poisoning
| |
| * [[Scombrotoxin]]
| |
| | |
| * [[Tetrodotoxin]] ([[fugu fish]] poisoning)
| |
| | |
| Some plants contain substances which are toxic in large doses, but have therapeutic properties in appropriate dosages.
| |
| * The [[foxglove]] contains [[belladonna]].
| |
| * Poisonous hemlock ([[conium]]) has medicinal uses.
| |
| | |
| ===Other pathogenic agents===
| |
| * [[Prion]]s, resulting in [[Creutzfeldt-Jakob disease]]
| |
| | |
| ==="Ptomaine poisoning"===
| |
| An early theory on the causes of food poisoning involved [[#Ptomaine|ptomaines]], [[alkaloid]]s found in decaying animal and vegetable matter. While some alkaloids do cause poisoning, the discovery of bacteria left the ptomaine theory obsolete and the word "ptomaine" is no longer used scientifically.
| |
| | |
| ==Global Impact==
| |
| | |
| In modern times, rapid globalization of food production and trade has increased the potential likelihood of food contamination. Many outbreaks of foodborne diseases that were once contained within a small community may now take place on global dimensions. [[Food safety]] authorities all over the world have acknowledged that ensuring food safety must not only be tackled at the national level but also through closer linkages among food safety authorities at the international level. This is important for exchanging routine information on food safety issues and to have rapid access to information in case of food safety emergencies."
| |
| | |
| It is difficult to estimate the global incidence of foodbourne disease, but it has been reported that in the year 2000 about 2.1 million people died from diarrhoeal diseases. Many of these cases have been attributed to contamination of food and drinking water. Additionally, diarrhoea is a major cause of malnutrition in infants and young children.
| |
| | |
| Even in industrialized countries, up to 30% of the population of people have been reported to suffer from foodborne diseases every year. In the U.S, around 76 million cases of foodborne diseases, which resulted in 325,000 hospitalizations and 5,000 deaths, are estimated to occur each year. Developing countries in particular, are worst affected by foodborne illnesses due to the presence of a wide range of dieases, including those caused by parasites. Foodborne illnesses can and did inflict serious and extensive harm on society. In 1994, an outbreak of salmonellosis due to contaminated ice cream occurred in the USA, affecting an estimated 224,000 persons. In 1988, an outbreak of hepatitis A, resulting from the consumption of contaminated clams, affected some 300,000 individuals in China.
| |
| | |
| Food contamination creates an enormous social and economic strain on societies. In the U.S., diseases caused by the major pathogens alone are estimated to cost up to US $35 billion annually (1997) in medical costs and lost productivity. The re-emergence of cholera in Peru in 1991 resulted in the loss of US $500 million in fish and fishery product exports that year.
| |
| | |
| ==Statistics==
| |
| Every year there are about 76 million foodborne illnesses in the United States (26,000 cases for 100,000 inhabitants), 2 million in the United Kingdom (3,400 cases for 100,000 inhabitants) and 750,000 in France (1,210 cases for 100,000 inhabitants).
| |
| | |
| ===United States===
| |
| In the United States, there are approximately 76 million foodborne illnesses (26,000 cases for 100,000 inhabitants):<ref>{{cite web
| |
| | url=http://www.who.int/mediacentre/factsheets/fs237/en/
| |
| | title=Food safety and foodborne illness
| |
| | pulisher=WHO}}</ref>
| |
| * 325,000 were hospitalized (111 per 100,000 inhabitants);
| |
| * 5,000 people [[death|died]] (1.7 per 100,000 inhabitants.).
| |
| * Major pathogens from food borne illness in the United States cost upwards of US $35 billion dollars in medical costs and lost productivity (1997)
| |
| | |
| ===France===
| |
| In France, for 750,000 cases(1,210 per 100,000 inhabitants):
| |
| * 70,000 people consulted in the emergency department of an hospital (113 per 100,000 inhab.);
| |
| * 113,000 people were hospitalized (24 per 100,000 inhabitants);
| |
| * 400 people died (0.9 per 100,000 inhabitants).
| |
| | |
| ===Australia===
| |
| In Australia, there are an estimated 5.4 million cases of food-borne illness every year, causing:<ref>{{cite web
| |
| | url=http://www.ozfoodnet.org.au/internet/ozfoodnet/publishing.nsf/Content/reports-1/$FILE/foodborne_report.pdf
| |
| | title=Food borne illness in Australia
| |
| | pulisher=OzFoodNet}}</ref>
| |
| * 18,000 hospitalisations
| |
| * 120 deaths
| |
| * 2.1 million lost days off work
| |
| * 1.2 million doctor consultations
| |
| * 300,000 prescriptions for antibiotics
| |
| | |
| {{Col-begin}}
| |
| {{Col-2}}
| |
| {|class="wikitable" style="font-size:95%"
| |
| |+ Causes of foodborne illness in France<ref>{{cite web
| |
| | url=http://www.invs.sante.fr/publications/2004/inf_origine_alimentaire/inf_origine_alimentaire.pdf
| |
| | title=Report of the French sanitary agencies
| |
| | publisher=INVS/Afssa
| |
| | language=French}}
| |
| </ref><ref>{{cite web
| |
| | url=http://www.invs.sante.fr/publications/2004/inf_origine_alimentaire/grilleLecture.pdf
| |
| | title=Summary of Report of the French sanitary agencies
| |
| | publisher=INVS/Afssa
| |
| | language=French}}
| |
| </ref>
| |
| |-
| |
| ! !! Cause !! Annual cases !! Rate<br /><small>(per 100,000 inhabitants)</small>
| |
| |-
| |
| | 1 || ''[[Salmonella]]'' || ~8,000 cases || align="center"|13
| |
| |-
| |
| | 2 || ''[[Campylobacter]]'' || ~3,000 cases || align="center"|4.8
| |
| |-
| |
| | 3 || [[Parasite]]s<br />incl. [[Toxoplasma]] || ~500 cases<br />~400 cases || align="center"|0.8<br />0.65
| |
| |-
| |
| | 4 || ''[[Listeria]]'' || ~300 cases || align="center"|0.5
| |
| |-
| |
| | 5 || [[Hepatitis A]] || ~60 cases || align="center"|0.1
| |
| |}
| |
| {{Col-2}}
| |
| {|class="wikitable" style="font-size:95%;"
| |
| |+ Causes of death by foodborne illness in France
| |
| |-
| |
| ! !! Cause !! Annual !! Rate<br><small>(per 100,000 inhabitants)</small>
| |
| |-
| |
| | 1 || ''[[Salmonella]]'' || ~300 cases || align="center"|0.5
| |
| |-
| |
| | 2 || ''[[Listeria]]'' || ~80 cases || align="center"|0.13
| |
| |-
| |
| | 3 || [[Parasite]]s || ~37 cases || align="center"|0.06<br />(95% due to [[toxoplasma]])
| |
| |-
| |
| | 4 || ''[[Campylobacter]]'' || ~15 cases || align="center"|0.02
| |
| |-
| |
| | 5 || [[Hepatitis A]] || ~2 cases || align="center"|0.003
| |
| |}
| |
| {{Col-end}}
| |
| | |
| ==Outbreaks==
| |
| The vast majority of reported cases of foodborne illness occur as individual or [[sporadic]] cases. The origin of most [[sporadic]] cases is undetermined. In the United States, where people eat outside the home frequently, most outbreaks (58%) originate from commercial food facilities (2004 FoodNet data). An outbreak is defined as occurring when two or more people experience similar illness after consuming food from a common source.
| |
| | |
| Often, a combination of events contributes to an outbreak, for example, food might be left at room temperature for many hours, allowing bacteria to [[multiplication|multiply]] which is compounded by inadequate cooking which results in a failure to kill the dangerously elevated bacterial levels.
| |
| | |
| Outbreaks are usually identified when those affected know each other. However, more and more, outbreaks are identified by [[public health]] staff from unexpected increases in laboratory results for certain strains of bacteria. Outbreak detection and investigation in the United States is primarily handled by local health jurisdictions and is inconsistent from district to district. It is estimated that 1–2% of outbreaks are detected.
| |
| | |
| ==Political issues==
| |
| ===United Kingdom===
| |
| In the UK serious outbreaks of foodborne illness since the 1970s prompted key changes in UK [[food safety]] law. These included the death of 19 patients in the Stanley Royd Hospital outbreak [http://briandeer.com/social/stanley-royd.htm] and the [[bovine spongiform encephalopathy]] (BSE, mad cow disease) outbreak identified in the 1980s. The death of 17 people in the [[1996]] Wishaw outbreak of E. coli O157 [http://www.scotland.gov.uk/deleted/library/documents-w4/pgr-00.htm] was a precursor to the establishment of the [[Food Standards Agency]] which, according to [[Tony Blair]] in the [[1998]] [[white paper]] [http://www.archive.official-documents.co.uk/document/maffdh/fsa/fsa.htm ''A Force for Change'' Cm 3830] "would be powerful, open and dedicated to the interests of consumers".
| |
| | |
| ===United States===
| |
| In 2001, the [http://www.cspinet.org/ Center for Science in the Public Interest (CSPI)] petitioned the [[United States Department of Agriculture]] to require meat packers to remove [[spinal cord]]s before processing cattle carcasses for human consumption, a measure designed to lessen the risk of infection by variant [[Creutzfeldt-Jakob disease]]. The petition was supported by the [[American Public Health Association]], the [[Consumer Federation of America]], the [[Government Accountability Project]], the [[National Consumers League]], and Safe Tables Our Priority. This was opposed by the [[National Cattlemen's Beef Association]], the National Renderers Association, the [[National Meat Association]], the Pork Producers Council, sheep raisers, milk producers, the Turkey Federation, and eight other organizations from the animal-derived food industry. This was part of a larger controversy regarding the United States' violation of [[World Health Organization]] proscriptions to lessen the risk of infection by variant Creutzfeldt-Jakob disease.
| |
| | |
| ==Organizations==
| |
| | |
| '''World Health Organization Food Safety Department'''
| |
| The WHO provides scientific advice for organizations and the public on issues concerning the safety of food. It serves as a medium linking the [[food safety]] systems in countries around the world. Food safety is currently one of WHO's top ten priorities.Food Safety is one of the major issues in our world today, and the Organization calls for more systematic and aggressive steps to be taken to significantly reduce the risk of foodborne diseases.
| |
| | |
| '''The Department of Food Safety, Zoonoses and Foodborne Diseases'''
| |
| The Department of Food Safety, Zoonoses and Foodborne Diseases is a department under the WHO. Its mission is to: to reduce the serious negative impact of foodborne diseases worldwide. According to the WHO website, food and waterborne diarrhoeal diseases are leading causes of illness and death in less developed countries, killing approximately 1.8 million people annually, most of whom are children
| |
| "WHO works closely with the Food and Agriculture Organization of the United Nations (FAO) to address food safety issues along the entire food production chain--from production to consumption--using new methods of risk analysis. These methods provide efficient, science-based tools to improve food safety, thereby benefiting both public health and economic development."
| |
| | |
| '''The International Food Safety Authorities Network (INFOSAN)'''
| |
| This Network is intended to complement and support the existing WHO Global Outbreak Alert and Response Network (GOARN) which includes a Chemical Alert and Response component.
| |
| | |
| == Academic resources ==
| |
| === Periodicals ===
| |
| * [http://www.sciencedirect.com/science/journal/01681605 International Journal of Food Microbiology], ISSN: 0168-1605, Elsevier
| |
| * Foodborne Pathogens and Disease, ISSN: 1535-3141, [[Mary Ann Liebert, Inc.]]
| |
| * Mycopathologia, ISSN: [http://www.springerlink.com/content/102966/ 1573-0832] (electronic) 0301-486X (paper), Springer
| |
| | |
| === Books ===
| |
| * Advances in Food Mycology (Advances in Experimental Medicine and Biology) (2006) by A.D. Hocking ''et al.'', ISBN-13: 978-0387283913 (electronic) 978-0387283852 (paper), Springer
| |
| * Foodborne Infections and Intoxications (2006) by Hans P. Riemann and Dean O. Cliver, ISBN 012588365X, Elsevier
| |
| * Foodborne Pathogens: Microbiology And Molecular Biology (2005) by Pina M. Fratamico ''et al.'', ISBN-10: 190445500X ISBN-13: 978-1904455004, Caister Academic Press
| |
| | |
| ==See also==
| |
| {{col-begin}}
| |
| {{col-3}}
| |
| * [[2006 North American E. coli outbreak]] | | * [[2006 North American E. coli outbreak]] |
| * [[Alexander Litvinenko poisoning]]
| |
| * [[Attack rate]] | | * [[Attack rate]] |
| * [[Centers for Disease Control and Prevention|United States Disease Control and Prevention]] | | * [[Centers for Disease Control and Prevention|United States Disease Control and Prevention]] |
| Line 634: |
Line 46: |
| * [[Food safety]] | | * [[Food safety]] |
| * [[Food Testing Strips]] | | * [[Food Testing Strips]] |
| {{col-3}}
| |
| * [[Gastroenteritis]] | | * [[Gastroenteritis]] |
| * [[ISO 16050]]
| |
| * [[Juice]] | | * [[Juice]] |
| * [[List of infectious diseases]] | | * [[List of infectious diseases]] |
| * [[List of poisonings]]
| |
| * [[List of foodborne illness outbreaks]] | | * [[List of foodborne illness outbreaks]] |
| * [[Meat borne diseases]]
| |
| * [[Milk borne diseases]]
| |
| {{col-3}}
| |
| * [[Mycotoxicology]] | | * [[Mycotoxicology]] |
| * [[Minamata disease]] | | * [[Minamata disease]] |
| * [[Munir Said Thalib]]
| |
| * [[Risk assessment]] | | * [[Risk assessment]] |
| {{col-end}}
| |
|
| |
| == Notes ==
| |
| <div class="references-small"><references/></div>
| |
|
| |
|
| ==External links== | | ==External Links== |
| * [http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5510a1.htm Surveillance for Foodborne-Disease Outbreaks --- United States, 1998--2002] | | * [http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5510a1.htm Surveillance for Foodborne-Disease Outbreaks --- United States, 1998--2002] |
| * [http://azarticles.com/Categories/Food_and_Drink/Preventing_Food_Poisoning.php Preventing Food Poisoning]
| |
| *[http://www.veriprime.org VeriPrime Food Safety Alliance New Farm to Fork Food Safety System]
| |
| *[http://www.foodsqm.com Food Safety News FoodSQM.com]
| |
| * [http://www.who.int/mediacentre/factsheets/fs124/en/ Foodborne diseases, emerging], [[WHO]], Fact sheet N°124, revised January 2002
| |
| * [http://www.foodauthority.nsw.gov.au/fb-foodborne-illness.htm Foodborne illness information pages], NSW Food Authority
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| * [http://www.who.int/mediacentre/factsheets/fs237/en/ Food safety and foodborne illness], [[WHO]], Fact sheet N°237, revised January 2002
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| *[http://www.hpa.org.uk/infections/ UK Health protection Agency] | | *[http://www.hpa.org.uk/infections/ UK Health protection Agency] |
| *[http://www.cdc.gov/pulsenet/ US PulseNet] | | *[http://www.cdc.gov/pulsenet/ US PulseNet] |
| *[http://science.ntu.ac.uk/external/Foodborne%20illness.html Nottingham Trent University Foodborne illness research data]
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| *[[Safe Tables Our Priority (S.T.O.P.)]]
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| *[http://www.foodlink.org.uk/factfile.asp?file=1 Food and Drink Federation Guide]
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| *[http://www.netdoctor.co.uk/health_advice/facts/salmonella.htm Salmonella food poisoning]
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| *[http://aggie-horticulture.tamu.edu/extension/poison.html Bacterial Food Poisoning]
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| *[http://www.bbc.co.uk/health/conditions/foodpoisoning1.shtml BBC Information]
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| *[http://www.nlm.nih.gov/medlineplus/ency/article/001652.htm Medline]
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| *[http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=411 UK NHS Information]
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| *[http://www.foodsafetynetwork.ca/en/ Food Safety Network]
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| *[http://dmoz.org/Health/Conditions_and_Diseases/Food_and_Water_Borne/ Open Directory Food and Water Borne Diseases Category]
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| *[http://www.arrowscientific.com.au/educational-material/food-poisoning.html Food poisoning basics]
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| *[http://www.who.int/ The World Health Organization] | | *[http://www.who.int/ The World Health Organization] |
| *[http://www.fda.gov/ The United States FDA] | | *[http://www.fda.gov/ The United States FDA] |
| *[http://www.food.gov.uk/ Food Standard Agency website]
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| *[http://active.inspection.gc.ca/eng/util/newrsse.asp?cid=44&scid= The Canadian Food Inspection Agency Website]
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| * Genome information for some of the organisms causing foodborne illness (diarrheagenic ''E. coli'' and ''Salmonella'') is available from the [http://www.ericbrc.org NIAID Enteropathogen Resource Integration Center (ERIC)]
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| [[Category:Nutrition]] | | [[Category:Nutrition]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Intensive care medicine]] | | [[Category:Intensive care medicine]] |
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