Foodborne Illness a Dynamic, Everywhere Possible Emergency Field Today

Abstract

Liana Monica Deac

Foodborne illness afflicts people throughout the world. The CDC defines a foodborne disease outbreak as the occurrence of two or more similar illnesses resulting from ingestion of a common food. Each year, in USA, one in 10 people experiences a foodborne illness, 128,000 are hospitalized, 3,000 die, and 33 million healthy life-years are lost. While few patients with foodborne illness present with life-threatening symptoms, there are a number of foodborne infectious diseases and toxins that the emergency physician or other health care provider must consider in the evaluation of these patients. Given the frequency of international travel, as well as the risk associated with recurrent outbreaks of foodborne illness from commercial food sources, it is important to recognize various syndromes of foodborne illness, including those, which may require specific evaluation and management strategies. Foodborne illness poses a significant public health threat to the United States. The disease is defined as any ailment associated with the ingestion of contaminated food and is most often associated with gastrointestinal symptoms, including diarrhea, nausea, and/or vomiting. Individuals who are aged less than 5 years or more than 60 years or who are immunocompromised are at greatest risk for acquiring a foodborne illness. The most common cause of gastroenteritis is Salmonella infection. Annually, nontyphoidal Salmonella causes 1.2 million cases of foodborne illness and 450 deaths. Most Salmonella outbreaks were attributed to seeded vegetables (6.9%), pork (4%), or vegetable row crops (1.7%). Adults older than 65 years, people with weakened immune systems, and non-breastfed infants are more likely to have severe infections. Approximately 8% of patients with nontyphoidal salmonellosis will develop bacteremia and require treatment with antibiotics, including ceftriaxone or azithromycin in children and a fluoroquinolone (commonly levofloxacin) or azithromycin in adults. The summer months (peaking in July or August) had the highest percentage of cases. The use of certain medications to reduce stomach acidity can increase the risk of Salmonella infection. The food safety systems in some countries afford better consumer protection than others. This situation, combined with differing climates and ecologies, results in the association of different types of foodborne illness with different regions of the world. In a global economy, both people and food travel the world. Clinicians need to consider foreign travel as well as the consumption of food from other parts of the world when determining the cause of foodborne disease. The key to reducing the incidence of foodborne illness is prevention. Proper food storage, refrigeration, handling, and cooking are vital. Patients should be educated to avoid high-risk items such as unpasteurized milk and milk products, as well as raw or undercooked items like oysters, meat, poultry, and eggs. The consumption of more meals in the home may also decrease the risk of foodborne illness.

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