FOODBORNE DISEASES: Classification by Symptoms, Incubation Period and Type of Agent.

Disease

Etiologic agent or source

Incubation period (latency)

Signs and symptoms

Food implicated ³

Specimens to be obtained

Contributing factors

Poisoning by mushrooms of the group that causes gastrointestinal irritation

Possibly resin-type substances found in some types of mushrooms

From 30 minutes to 2 hours

Nausea, vomiting, retching, diarrhea, abdominal pains

Many varieties of wild mushrooms

Vomit

Ingestion of unknown toxic varieties of mushrooms, through confusion with other edible varieties

Antimony poisoning

Antimony in enameled iron utensils

From a few minutes to 1 hour

Vomiting, abdominal pains, diarrhea

Very acid food and beverages

Vomit, stool, urine

Use of utensils that contain antimony, storage of very acid food in enameled iron utensils

Cadmium poisoning

Cadmium in plated utensils

From 15 to 30 minutes

Nausea, vomiting, abdominal pains, diarrhea, shock

Very acid foods and drinks, candies and other cake decorations

Vomit, stool, urine, blood

Use of utensils that contain cadmium, storage of very acid food in containers that contain cadmium, ingestion of foods that contain cadmium

Copper poisoning

Copper in pipes and utensils

From a few minutes to a few hours

Metallic taste, nausea, vomiting (green vomit), abdominal pains, diarrhea

Very acid food and beverages

Vomit, gastric lavage, urine, blood

Storage of very acid food in copper utensils or use of copper tubing in serving very acid beverages, defective valves on devices to prevent reflux (in dispensers)

Fluoride poisoning (fluorosis)

Sodium fluoride in insecticides

From a few minutes to two hours

Salty or soapy taste, numbness in the mouth, vomiting, diarrhea, abdominal pains, pallor, cyanosis, dilated pupils, spasms, collapse, shock

Any accidentally contaminated food particularly dry food such as powdered milk, flour, baking powder and cake mixes

Vomit, gastric lavages

Storage of insecticides in the same place as food, confusion of pesticides with powdered foods

Lead poisoning

Lead contained in earthenware pots, pesticides, paints, plaster, putty

30 minutes or more

Metallic taste, burning in the mouth, abdominal pains, milky vomit, black stool or presence of blood, bad breath, shock, blue line at the edge of gums ("lead line")

Very acid food and beverages stored in vessels containing lead, any accidentally contaminated food

Vomit, gastric lavages, stool, blood, urine

Use of vessels containing lead, storage of very acid food in vessels containing lead, storage of pesticides in the same places as food

Tin poisoning

Tin in tin cans

From 30 minutes to 2 hours

Swelling, nausea, vomiting, abdominal pains, diarrhea, headache

Very acid foods and beverages

Vomiting, stool, urine, blood

Storage of acid foods in unlined tin containers

Zinc poisoning

Zinc in galvanized containers

From a few minutes to two hours

Mouth and abdominal pains, nausea, vomiting, dizziness

Very acid food and beverages

Vomit, gastric lavages, urine, blood, stool

Storage of very acid food in galvanized tins

Bacillus cereus gastroenteritis (type emetic)

Exoenterotoxin of B.Céreus

From 1/2 to 5 hours

Nausea, vomiting, occasionally diarrhea

Cooked or fried rice, plates of rice with meat

Vomiting, stool

Storage of cooked food at warm temperatures, food cooked in large containers, food prepared several hours before serving

Staphylococcal food poisoning

Exoenterotoxins A, B, C, D and E of Staphylococcus aureus. Staphylococci from the nose, skin, and lesions of infected people and animals, and infected udders of cows

From 1 at 8 hours, average of 2 to 4 hours

Nausea, vomiting, retching, abdominal pains, diarrhea, prostration

Ham, beef or poultry products, cream-filled pastries, food mixes, leftover food

Patient: vomit, stool, rectal swab.

Carrier: nasal swabs, swabs from lesion, and rectal swabs

Inadequate refrigeration, handler touched cooked food, preparation of food several hours before serving, handlers with purulent infections, food kept at warm temperatures (bacterial incubation), fermentation of foods abnormally of low in acids

Nitrite Poisoning

Nitrites or nitrates used as compounds to cure meat, or water from shallow wells

From 1 to 2 hours

Nausea, vomiting, cyanosis, headache, dizziness, weakness, loss of consciousness, chocolate-colored blood

Cured meats, any accidentally contaminated food, exposure to excessive nitrification

Blood

Use of excessive quantities of nitrites or nitrates to cure food or conceal spoilage, confusion of nitrites with common salt, and other condiments, inadequate refrigeration, excessive nitrification in fertilized food

Diarrheal Shellfish Poisoning (DSP)

Okadaico acid and other toxins produced by dinoflagellates of the species Dinophysis spp.

From 1/2 to 12 hours, usually 4 hours

Diarrhea, nausea, abdominal pains

Mussels, clams, oysters

Gastric rinse

Shellfish caught in water with high concentration of Dynophysis spp.

Poisoning caused by mushrooms of the cyclopeptide and Giromitra groups

Cyclopeptides and gyromitrine found in certain mushrooms

From 6 to 24 hours

Abdominal pains, feeling of fullness, vomiting, prolonged diarrhea, loss of strength, thirst, muscle cramps, rapid and weak pulse, collapse, jaundice, somnolence, dilated pupils, coma, death

Amanita phalloides, A. verna, Galerina autumnalis. Esculenta giromitra (false colmenilla) and similar species of mushrooms

Urine, blood, vomit

Ingestion of certain species of Amanita, Galerina and Giromitra mushrooms, ingestion of unknown varieties of mushrooms, confusion of toxic mushrooms with edible varieties

Small round viruses, productive of gastroenteritis

Includes adenovirus, coronavirus, rotavirus, parvovirus, calicivirus, and astrovirus

1/2 to 3 days, usually 36 hours

Nausea, vomiting, diarrhea, abdominal pain, myralgias, headache, light fever. Duration 36 hours

Human feces

Stool, blood in acute and convalescent phases

Infected people who touch food ready for consumption, harvest of shellfish from contaminated waters, improper disposal of wastes, use of contaminated water

Calcium chloride poisoning

Freezing mixtures of calcium chloride for freezing desserts

A few minutes

Burning in the tongue, mouth, and throat, vomiting

Frozen desserts

Vomit

Contamination of popsicles during freezing, permitting the introduction of calcium chloride in the syrup

Sodium hydroxide poisoning

Sodium hydroxide (caustic soda) in compounds used to wash bottles, detergent, drain cleaners, hair-relaxants

A few minutes

Burning of the lips, mouth and throat; vomiting, abdominal pains, diarrhea

Bottled beverages

Vomit

Improper rinsing of bottles washed with caustic substances

Infections by beta-hemolytic streptococci

Streptococcus pyogenes of the throat and lesions of infected people

From 1 to 3 days

Pharyngitis, fever, nausea, vomiting, rhinorrhea, sometimes rash

Raw milk, foods containing egg

Pharyngeal swabs, vomit

Workers who touched cooked food, workers with purulent infections, inadequate refrigeration, improper cooking or reheating, preparation of food several hours before serving

Gastroenteritis by Bacillus cereus (diarrheal type)

Exoenterotoxin of B. cereus, organisms in the soil

From 8 to 16 hours; average 12 hours

Nausea, abdominal pains, diarrhea

Foods made from grains, rice, custard, sauces, meatballs, sausages, cooked vegetables, dehydrated or reconstituted products

Stool

Inadequate refrigeration, storage of food at warm temperatures (bacterial incubation), preparation of food several hours before serving, improper reheating of leftovers

Gastroenteritis caused by Clostridium perfringens

Endoenterotoxin formed during the sporulation of C. perfringens in the intestines, the body, in human or animals feces or in the soil

From 8 to 22 hours, average of 10 hours

Abdominal pains, diarrhea

Cooked beef or poultry, broths, sauces, and soups

Stool

Inadequate refrigeration, storage of food at warm temperatures (bacterial incubation), preparation of food several hours before serving, improper reheating of leftover food

Diarrheal diseases caused by aeromonas

1 to 2 days

Watery diarrhea, abdominal pain, nausea, headache

Fish, shellfish, snails, water

Stool

Contamination of food in sea or surface water

Campylobacter Infection

Campylobacter jejuni

2 to 7 days usually between 3 and 5

Abdominal pains, diarrhea (frequently with mucus and blood), headache, myralgias, fever, anorexia, nausea, vomiting. Sequella: Guillian-Barre syndrome

Raw milk, beef liver, raw clams, ater

Stool or rectal swabs, blood

Drinking raw milk, handling raw products, eating raw or undercooked poultry, inadequate cooking or pasteurization, cross-contamination with raw meat

Cholera

Endoenterotoxin of Vibrio cholerae classical and El Tor biotypes, from feces of infected persons

From 1 to 3 days

Severe, watery diarrhea (rice water stools), vomiting, abdominal pains, dehydration, thirst, collapse, loss of skin tone, shriveled fingers, sunken eyes

Raw fish and shellfish, food washed or prepared with contaminated water, water

Stool

Harvesting of fish and shellfish from water contaminated with sewage in endemic areas, poor personal hygiene, infected handlers who touched food, inadequate cooking, use of contaminated water in washing or rinsing food, improper disposal of wastewater, use of waste from latrines as fertilizer

Gastroentreritis caused by Vibrio similar cholera

Gastroenteritis caused by Escherichia coli pathogen

From 5 to 48 hours, average from 10 to 24 hours

Abdominal pains, diarrhea, nausea, vomiting, fever, chills, headache, myralgia

Various foods, water

Stool, rectal swabs

Infected handlers who touch food, insufficient cooling, incomplete cooking, improper cleaning and disinfection of equipment

Diarrheal diseases caused by Escherichia coli, Enterohemorrhagic or Vero-cytotoxin

E. coli O157:H7, O26, O111, O115, O113

1 to 10 days usually 2 to 5 days

Watery diarrhea followed by bloody diarrhea, severe abdominal pain, blood in the urine. Sequella: Hemolytic uremic syndrome

Hamburger, raw milk, sausages, yogurt, lettuce, water

Stool, rectal swabs

Hamburger made from meat of infected animals, consumption of raw meat and milk, inadequate cooking, cross-contamination, infected people touching food ready for consumption, improper desiccation and fermentation of meats.

Diarrea caused Echerichia coli Enteroinvasiva

Strains of E. Coli Enteroinvasiva

1/2 to 3 days

Severe abdominal pain, fever, watery diarrhea, (usually with mucus and blood present) tenesmus

Salads and other food that are not subsequently treated, water

Stool, rectal swabs

Inadequate cooking, infected persons touching food ready for consumption, not washing hands after defecation, storing food at room temperature, storing food in the refrigerator in large containers, preparing food several hours before serving, improper reheating of food

Diarrhea caused by Escherichia coli Enterotoxigenic

Strains of E. Coli Enterotxigenic a

1/2 to 3 days

Profuse watery diarrhea (without mucus or blood) abdominal pain, vomiting, prostration, dehydration, light fever

Salads and other food that are not subsequently thermally treated, fresh cheeses, water

Stool, rectal swabs

Inadequate cooking, infected people touching food ready for consumption, not washing hands after defecation, storage of food at room temperature, keeping food in the refrigerator in large containers, preparing food several hours before serving, improper reheating of food, use of raw milk in making cheese.

Enteritis by Plesiomonas

Pleisomonas shigeloides

1 to 2 days

Diarrhea with mucus and blood in the stool

Water

Stool, rectal swabs

Inadequate cooking

Salmonellosis

Various serotypes of Salmonella from feces of infected people and animals

From 6 to 72 hours, average from 18 to 36 hours

Abdominal pains, diarrhea, chills, fever, nausea, vomiting, malaise

Beef and poultry and their by-products, egg products, other foods contaminated with salmonellae

Stool, rectal swabs

Inadequate refrigeration, storage of food at warm temperatures (bacterial incubation), inadequate cooking and reheating, preparation of food several hours before serving, cross-contamination, improper cleaning of equipment, infected handlers who touch cooked food, acquisition of food from contaminated sources.

Shigellosis

Shigella flexneri, S. dysenteriae, S. sonnei and S. boydii

From 1/2 to 7 days, usually from 1 to 3 days

Abdominal pains, diarrhea, mucoid feces with blood present, fever

Any food ready for consumption that becomes contaminated, frequently salads, water

Stool, rectal swabs

Infected handlers touching the food, inadequate refrigeration, improper cooking and reheating

Gastroenteritis caused by Vibrio parahaemolyticus

V. parahaemolyticus from sea water or marine products

From 2 to 48 hours, average 12 hours

Abdominal pains, diarrhea, nausea, vomiting, fever, chills, headache

Raw or recontaminated sea food, shellfish

Stool, rectal swabs

Inadequate cooking, inadequate refrigeration, cross-contamination, improper cleaning of equipment, use of sea water in preparing food

Diarrhea caused by Yersiniosis

Yersinia, Enterocolítica pseudotuberculosis

1 to 7 days

Abdominal pains (can simulate appendicitis), light fever, headache, discomfort, anorexia, nausea, vomiting

Raw milk, water

Stool, rectal swabs

Inadequate cooking or pasteurization, cross-contamination, contaminated ingredients or water

Viral gastroenteritis

Enteric viruses (echovirus, coxsackievirus, reovirus, adenovirus)

From 3 to 5 days

Diarrhea, fever, vomiting, abdominal pains, sometimes respiratory symptoms

Food ready for consumption

Stool

Poor personal hygiene, infected workers touching food, improper cooking and reheating

Ascaridiasis

Ascaris lumbricides

14 to 20 days

Stomach disorders, cramps, vomiting, fever

Vegetables and water

Stool

Inadequate waste disposal, poor hygiene in food handling

Amebic dysentery (amebiasis)

Entamoeba histolytica

From a few days to several months usually between 2 and 4 weeks

Abdominal pains, constipation or diarrhea with blood and mucus

Vegetables and raw fruits

Stool

Poor personal hygiene, infected handlers touching the food, improper cooking and reheating

Fasciolasis

Fasciola hepatica

From 4 to 6 weeks

Fever, sweating, abdominal pain, coughing, bronchial asthma, itching

Aquatic plants or plants with high moisture content

Stool, tissue biopsy

Inefficient disposal of human and animal waste

Anisakiasis

Anisakis, pseudoterranova

From 4 to 6 weeks

Stomach pain, nausea, vomiting, abdominal pain

Rock fish, herring, cod, salmon, squid, sushi

Stool

Ingestion of raw or undercooked fish

Taeniasis due to Taenia saginata (beef tapeworm)

Taenia saginata from meat from meat of infected cattle

From 8 to 14 weeks

General malaise, hunger, weight loss, abdominal pains

Raw or undercooked meat

Stool

Failure to inspect meat, improper cooking, improper wastewater disposal, pasture contaminated by wastewater

Cyclosporosis

Cyclospora cayetanensis

1 to 11 days, usually 7 days

Prolonged watery diarrhea, weight loss, fatigue, nausea, anorexia, abdominal pain

Raspberries, lettuce, sweet basil, water

Stool

Irrigation with contaminated waters, washing fruit with contaminated water, possibly handling food ready for consumption

Cryptosporidiosis

Cryptosporidium parvum

1 to 12 days, usually 7 days

Profuse watery diarrhea, abdominal pain, anorexia, vomiting, light fever

Apple cider, water

Stool, intestinal biopsy

Improper disposal of animal wastes, contamination from the animal environment, inadequate filtering of water

Diphyllobotriasis (fish tapeworm infection)

Diphyllobothrium latum from flesh of infected fish

From 5 to 6 weeks

Undefined gastrointestinal discomfort, anemia may occur

Raw or undercooked fresh water fish

Stool

Inadequate cooking, improper wastewater disposal, lakes contaminated by wastewater

Giardiasis

Giardia lamblia from feces of infected people

From 1 to 6 weeks

Abdominal pains, diarrhea with mucus, fatty stools

Raw fruits and vegetables, water

Stool

Poor personal hygiene, infected handlers touching food, improper cooking, improper wastewater disposal

Taeniasis due to Taenia solium (pork tapeworm)

Taenia solium from infected pork

From 3 to 6 weeks

General malaise, hunger, weight loss

Raw or undercooked pork

Feces

Failure to inspect meat, improper cooking, improper wastewater disposal, grasses contaminated by wastewater

Mushroom poisoning from the group that contains ibotenic acid

Ibotenic and muscimol found in certain mushrooms

From 30 to 60 minutes

Somnolence and state of intoxication, confusion, muscular spasms, delirium, visual disorders

Amanita muscaria, A. pantherina, and related species of mushrooms

Ingestion of Amanita muscaria and related species of mushrooms, ingestion of unknown varieties of mushrooms, confusion of toxic mushrooms with edible varieties

Poisoning caused by mushrooms of the group that contains muscarine (muscarinism)

Muscarine found in certain mushrooms

15 min. to a few hours

Excessive salivation, perspiration, lacrimation, drop in blood pressure, irregular pulse, contraction of the pupils, blurred vision, asthmatic breathing

Clitocybe dealbata, C. rivulose, and many species of Inocybe and Boletus mushrooms

Vomit

Ingestion of A. muscaria and related species, consumption of unknown varieties of mushrooms, consumption of toxic mushrooms by mistake

Organophos-phorus poisoning

Organophos-phorus insecticides, such as parathion, TEPP, diazinon, malathion

From a few minutes to a few hours

Nausea, vomiting, abdominal pains, diarrhea, headache, nervousness, blurred vision, chest pains, cyanosis, confusion, spasmodic contraction, convulsions

Any accidentally contaminated food

Blood, urine, adipose tissue (for biopsy)

Spraying of crops immediately before harvest, storage of insecticides in the same place as food, confusion of pesticides with food in powdered form

Carbamate poisoning

Carbaryl (sevin), Temik (aldicarb)

1/2 hour

Epigastric pain, vomiting, abnormal salivation, contraction of the pupils, lack of muscular coordination

Any accidentally contaminated food

Blood, urine

Improper application to crops, storage in the same areas as food, mistaking for food in powdered form

Dinoflagellates

Paralytic Shellfish Poisoning (PSP)

Saxitoxin and other dinoflagellate toxins of the species Alexandrium and Gymnodinium

Several minutes to 30 minutes

Tingling, burning, and numbness around the lips and the tips of the fingers, dizzy spells, incoherent speech, respiratory paralysis

Mussels and clams

Gastric lavage

Harvesting shellfish from water with high concentrations of dinoflagellates of the species Alexandrium and Gymnodinium

Tetrodotoxism (tetraodon poisoning)

Tetrodoxin found in the intestines and gonads of puffer fish (blowfish, globefish)

From 10 minutes to 3 hours

Sensation of tingling in the fingers and toes, dizziness, pallor, numbness of the mouth and limbs, gastrointestinal symptoms, hemorrhage and flaking of the skin, fixation of the eyes, spasmodic contraction, paralysis, cyanosis

Fish of the puffer fish family

Ingestion of fish of the puffer fish family, consumption of such fish without extracting intestines and gonads

Jimsonweed (thorn apple) poisoning

Tropane alkaloids found in QDatura strmonium (Jimsonweed (thorn apple) poisoning)

Less than 1 hour

Abnormal thirst, photophobia, distorted vision, difficulty speaking, delirium, facial flushing, delirium, coma, rapid pulse heart attack.

Any part of the herb, tomatoes grown with grafts

Urine

Consumption of any part of the Jimson weed or consumption of tomatoes grown with grafts

Water hemlock poisoning

Resin or cicutoxin found in water hemlock

From 15 to 60 minutes

Excessive salivation, nausea, vomiting, stomach pains, frothing at the mouth, irregular breathing, convulsions, respiratory paralysis

Root of water hemlock, (Cicuta virosa and C. masculata)

Urine

Ingestion of water hemlock; confusion of the root of water hemlock with wild parsnip, sweet potato, or carrot

Chlorinated hydrocarbon poisoning

Insecticides containing chlorinated hydrocarbon, such as aldrin, chlordane, DDT, dieldrin, endrin, lindane, and toxaphene

From 30 minutes to 6 hours

Nausea, vomiting, paresthesia, dizziness, muscular weakness, anorexia, weight loss, confusion

Any accidentally contaminated food

Blood, urine, stool, gastric lavages

Storage of insecticides in the same place as food, confusion of pesticides with food in powdered form

Marine Plankton

Ciguatera poisoning

Ciguatoxin from the intestines, roe, gonads, and flesh of tropical marine fish

From 3 to 5 hours, sometimes more

Tingling and numbness around the mouth, metallic taste, dryness of the mouth, gastrointestinal symptoms, watery stool, myalgia, dizziness, dilated pupils, blurred vision, prostration, paralysis

Numerous varieties of tropical fish

Ingestion of liver, intestines, roe, gonads, or flesh of tropical reef fish; in general the large reef fish are more likely to be toxic

Botulism

Exoneurotoxins A, B, E and F from Clostridium botulinum. The spores are found in soil and animal intestines

From 2 hours to 8 days, average from 18 to 36 hours

Vertigo, double or blurred vision, dryness of the mouth, difficulty in swallowing, speaking and breathing; descending flaccid paralysis, constipation, dilation or fixation of the pupils, respiratory paralysis. Gastro-intestinal symptoms can precede neurological symptoms. Is frequently fatal

Home-canned foods with low acid content, vacuum-packed fish; fermented roe, fish and marine mammals, fish that have not been gutted

Blood, stool, gastric lavage

Improper preparation of canned food and smoked fish, uncontrolled fermentation

Mercury poisoning

Ethyl and methyl compounds of mercury in industrial waste and organic mercury in fungicides

1 week or more

Numbness, weakness of the legs, spastic paralysis, deterioration in the vision, blindness, coma

Grains treated with fungicides that contain mercury; pork, fish, and shellfish exposed to mercury compounds

Urine, blood, hair

Fish caught in waters contaminated with mercury compounds, animals fed with grains treated with fungicides containing mercury, ingestion of mercury, ingestion of grains treated with mercury or meat from animals fed with those grains

Triorthocresyl phosphate poisoning

Triorthocresyl phosphate used as an extract or as a substitute for kitchen oil

From 5 to 21 days, average 10 days

Gastrointestinal symptoms, pains in the legs, very accentuated equine gait, limpness of feet and wrists

Cooking oils, extracts and other foodstuffs contaminated with triorthocresyl phosphate

Biopsy of the gastronemius muscle

Use of the compound as an extract or as oil for cooking or for salads

Infection caused by Vibrio vulnificus

Vibrio vulnificus

16 hours

Septicemia, fever, malaise, prostration, typical of cases with previous liver problems

Oysters and raw clams

Blood

People with liver problems

Anthrax

Bacillus anthracis

From 3 to 5 days

Gastroenteritis, vomiting, hemorrhagic depositions

Meat from sick animals

Stool, vomiting

Clinical manifestations after consumption of meat from sick animals

Brucellosis

Brucella abortus, B. melitensis, and B. suis in tissues and milk of infected animals

From 7 to 21 days

Fever, chills, sweats, weakness, malaise, headache, myalgia and arthralgia, weight loss

Raw milk, goat cheese made with raw milk

Blood

Unpasteurized milk, livestock infected by brucellosis

Tuberculosis

Mycobacterium bovis

???

Lung lesions basically but also in kidneys, liver, spleen and corresponding nodes

Milk

Culture from secretions or tissues

Consumption of raw milk

Listeria Infection

Listeria monocytogenes

3 to 70 days, usually 4 to 21 days

Fever, headache, nausea, vomiting, abortion, meningitis, encephalitis, and sepsis

Milk, fresh cheese, processed meats

Blood, urine

Improper cooking, non-pasteurization of milk, prolonged cooling

Typhoid and paratyphoid fever

Salmonella typhi found in feces of infected people, other serotypes (as paratyphi A, cholerasuis) for cases of paratyphoid, feces of humans and animals

From 7 to 28 days, average 14 days

Malaise, headache, fever, cough, nausea, vomiting, constipation, abdominal pains, chills, rose spots, bloody stool

Shellfish, food contaminated by handlers, raw milk, cheese, watercress, water

Stool, rectal swabs, blood in early part of the acute phase, urine in the acute phase

Infected handlers touching food, poor personal hygiene, improper cooking, inadequate refrigeration, improper wastewater disposal, acquisition of food from contaminated sources, harvesting of shellfish from waters contaminated with sewage

Hepatitis A (infectious hepatitis)

Hepatitis A virus found in the feces, urine, or blood of infected people and other infected non-human primates

From 10 to 50 days, average 25 days

Fever, malaise, lassitude, anorexia, nausea, abdominal pains, jaundice

Shellfish, any food contaminated with hepatitis virus, water

Stool, urine, blood

Infected handlers touching food, poor personal hygiene, improper cooking, harvesting shellfish from waters contaminated with sewage, improper disposal of wastewater

Hepatitis E

Hepatitis E virus

From 15 to 65 days usually 35 to 40

Similar to above (high mortality for pregnant women)

Shellfish, any food contaminated with hepatitis virus, water

Stool, urine, blood

Infected handlers touching food, poor personal hygiene, improper cooking, harvesting shellfish from waters contaminated with sewage, improper disposal of wastewater

Angiostrongy-liasis (Eosinophilic meningoence-phalitis)

Angiosgtrongylus cantonensis (lung-worm of rats) found in rodent droppings and the soil

From 14 to 16 days

Gastroenterítis, headache, stiffness of the neck and back, low-grade fever

Crabs, prawns, slugs, shrimp, raw snails

Blood

Improper cooking

Toxoplasmosis

Toxoplasma gondii found in tissues and meat of infected animals

From 10 to 13 days

Fever, headache, myalgia, cutaneous rash

Raw or undercooked meat

Lymph nodes (for biopsy), blood

Improper cooking of mutton, pork, beef or veal

Trichinosis

Trichinella spiralis found in pork and bear meat

From 4 to 28 days, average 9 days

Gastroenteritis, fever, edema around the eyes, myalgia, chills, prostration, difficulty breathing

Pork, bear, walrus

Muscle tissue (for biopsy)

Ingestion of undercooked pork or bear meat, improper cooking or temperatures, feeding pigs with garbage that has not been cooked or properly treated with heat

Scombroid poisoning (Histamine Poisoning)

Histamine-like substances produced by Proteus spp. or other histidine bacteria found in the flesh of fish

From a few minutes to 1 hour

Headache, dizziness, nausea, vomiting, peppery taste, burning in the throat, facial swelling and flushing, stomachache, pruritis

Tuna fish, blue mackerel, Pacific dolphin, cheese

Vomit

Inadequate refrigeration of scombroid fish, improper curing of cheese

Monosodium glutamate poisoning

Excessive quantity of monosodium glutamate

From a few minutes to 1 hour

Burning sensation in the back of the neck, forearms and chest; tightness, tingling, facial flushing, dizziness, headache, nausea

Food seasoned with monosodium glutamate

Use of excessive quantities of monosodium glutamate to enhance flavor. Only some individuals are sensitive to the MSG

Nicotinic acid poisoning (niacin)

Sodium nicotinate used as color preservative

From a few minutes to an hour

Reddening, hot flashes, pruritis, abdominal pains, swelling of the face and knees

Meat or other food to which sodium nicotinate has been added

Use of sodium nicotinate to preserve color