View source for Medicine:Foodborne illness

{{Short description|Illness from eating spoiled food}}
{{Use mdy dates|date=February 2015}}
{{Food safety}}

'''Foodborne illness''' (also known as '''foodborne disease''' and '''food poisoning''')<ref>
{{DorlandsDict|nine/000952820|food poisoning}}
</ref> is any illness resulting from the contamination of food by pathogenic [[Biology:Bacteria|bacteria]], [[Biology:Virus|virus]]es, or [[Biology:Parasite|parasite]]s,<ref name=CDC>{{cite web
 |url=https://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm
 |access-date=3 July 2016
 |title=Foodborne Illness - Frequently Asked Questions
 |publisher=US Centers for Disease Control and Prevention
 |url-status=dead
 |archive-url=https://web.archive.org/web/20110303025929/http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm
 |archive-date=March 3, 2011
}}
</ref> as well as prions (the agents of mad cow disease), and [[Biology:Toxin|toxin]]s such as [[Chemistry:Aflatoxin|aflatoxin]]s in peanuts, poisonous mushrooms, and various species of [[Biology:Bean#Toxins|beans]] that have not been boiled for at least 10 minutes.

Symptoms vary depending on the cause. They often include [[Medicine:Vomiting|vomiting]], [[Medicine:Fever|fever]], and aches, and may include [[Medicine:Diarrhea|diarrhea]]. Bouts of vomiting can be repeated with an extended delay in between. This is because even if infected food was eliminated from the stomach in the first bout, microbes, like bacteria (if applicable), can pass through the [[Biology:Stomach|stomach]] into the [[Chemistry:Intestine|intestine]] and begin to multiply. Some types of microbes stay in the intestine.

For contaminants requiring an [[Medicine:Incubation period|incubation period]], symptoms may not manifest for hours to days, depending on the cause and on the quantity of consumption. Longer incubation periods tend to cause those affected to not associate the symptoms with the item consumed, so they may misattribute the symptoms to [[Medicine:Gastroenteritis|gastroenteritis]], for example.

==Causes==
{{see also|Biology:Pathogen}}
[[File:Foodinfridgetext.jpg|thumb|Poorly stored food in a refrigerator]]
Foodborne illness usually arises from improper handling, preparation, or [[Engineering:Food storage|food storage]]. Good hygiene practices before, during, and after food preparation can reduce the chances of contracting an illness. There is a consensus in the public health community that regular hand-washing is one of the most effective defenses against the spread of foodborne 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.<ref>For foodborne illness caused by chemicals, see Food contaminants.</ref>

Furthermore, foodborne illness can be caused by a number of chemicals, such as [[Biology:Pesticide|pesticide]]s, [[HandWiki:Medicine|medicine]]s, and natural toxic substances such as [[Chemistry:Vomitoxin|vomitoxin]], [[Medicine:Mushroom poisoning|poisonous mushrooms]] or [[Chemistry:Tetrodotoxin|reef fish]].<ref>{{cite web|url=https://www.fda.gov/food/chemicals-metals-pesticides-food | title = Chemicals, Metals & Pesticides in Food |website = [[Organization:Food and Drug Administration|Food and Drug Administration]] | date= 2021 }}</ref>

===Bacteria===
[[Biology:Bacteria|Bacteria]] are a common cause of foodborne illness. In 2000, the United Kingdom reported the individual bacteria involved as the following: ''[[Biology:Campylobacter jejuni|Campylobacter jejuni]]'' 77.3%, ''[[Biology:Salmonella|Salmonella]]'' 20.9%, [[Medicine:Escherichia coli O157:H7|''Escherichia coli'' O157:H7]] 1.4%, and all others less than 0.56%.<ref>{{cite web
 |url=http://food.gov.uk/enforcement/regulation/betregs/ria/ria2011/controllingecoliia2011
 |access-date=14 August 2016
 |title=Reducing the risk from ''E. coli'' 0157 – controlling cross-contamination
 |publisher=Food Standards Agency, United Kingdom
 |date=February 2011
 |url-status=bot: unknown
 |archive-url=https://web.archive.org/web/20140416193433/http://food.gov.uk/enforcement/regulation/betregs/ria/ria2011/controllingecoliia2011
 |archive-date=April 16, 2014
 |df=mdy
}}
</ref>

In the past, bacterial infections were thought to be more prevalent because few places had the capability to test for [[Medicine:Norovirus|norovirus]] and no active surveillance was being done for this particular agent. Toxins from bacterial infections are delayed because the bacteria need time to multiply. As a result, symptoms associated with intoxication are usually not seen until 12–72 hours or more after eating contaminated food. However, in some cases, such as Staphylococcal food poisoning, the onset of illness can be as soon as 30 minutes after ingesting contaminated food.<ref>{{cite web|url=https://www.cdc.gov/foodsafety/diseases/staphylococcal.html |title=Staphylococcal Food Poisoning |access-date=3 July 2016 |publisher=U.S. Centers for Disease Control and Prevention}}</ref>

[[File:SalmonellaNIAID.jpg|right|200px|thumb|''Salmonella'']]
A 2022 study concluded that washing uncooked chicken could increase the risk of [[Biology:Pathogen|pathogen]] transfer, and that specific washing conditions can decrease the risk of transfer.<ref>{{Cite web |last1=Chemistry |first1=University of |last2=Prague |first2=Technology |title=Chickensplash! Exploring the health concerns of washing raw chicken |url=https://phys.org/news/2022-09-chickensplash-exploring-health-raw-chicken.html |access-date=2022-10-03 |website=phys.org |language=en}}</ref><ref>{{cite journal | vauthors = Carmody CD, Mueller RC, Grodner BM, Chlumsky O, Wilking JN, McCalla SG | title = Chickensplash! Exploring the health concerns of washing raw chicken | journal = Physics of Fluids | volume = 34 | issue = 3 | pages = 031910 | date = March 2022 | pmid = 35392485 | pmc = 8958727 | doi = 10.1063/5.0083979 | bibcode = 2022PhFl...34c1910C }}</ref>

Most common bacterial foodborne pathogens are:
* ''[[Biology:Campylobacter|Campylobacter jejuni]]'' which can lead to secondary [[Medicine:Guillain–Barré syndrome|Guillain–Barré syndrome]] and periodontitis<ref name=cazp>{{cite journal | vauthors = Humphrey T, O'Brien S, Madsen M | title = Campylobacters as zoonotic pathogens: a food production perspective | journal = International Journal of Food Microbiology | volume = 117 | issue = 3 | pages = 237–257 | date = July 2007 | pmid = 17368847 | doi = 10.1016/j.ijfoodmicro.2007.01.006 }}</ref>
* ''[[Biology:Clostridium perfringens|Clostridium perfringens]]'', the "cafeteria germ"<ref name=USDA>
{{cite web| title = Foodborne Illness: What Consumers Need to Know| work = USDA.gov| access-date = 14 August 2016| url = http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/foodborne-illness-and-disease/foodborne-illness-what-consumers-need-to-know/CT_Index}}
</ref><ref>{{cite journal | vauthors = Kiu R, Caim S, Painset A, Pickard D, Swift C, Dougan G, Mather AE, Amar C, Hall LJ | display-authors = 6 | title = Phylogenomic analysis of gastroenteritis-associated ''Clostridium perfringens'' in England and Wales over a 7-year period indicates distribution of clonal toxigenic strains in multiple outbreaks and extensive involvement of enterotoxin-encoding (CPE) plasmids | journal = Microbial Genomics | volume = 5 | issue = 10 | pages = e000297 | date = October 2019 | pmid = 31553300 | pmc = 6861862 | doi = 10.1099/mgen.0.000297 | doi-access = free }}</ref>
* ''[[Biology:Salmonella|Salmonella]]'' spp. – its ''S.&nbsp;typhimurium'' infection is caused by consumption of eggs or poultry that are not adequately cooked or by other interactive human-animal pathogens<ref name=aoostpt>
{{cite journal | vauthors = Tribe IG, Cowell D, Cameron P, Cameron S | title = An outbreak of Salmonella typhimurium phage type 135 infection linked to the consumption of raw shell eggs in an aged care facility | journal = Communicable Diseases Intelligence Quarterly Report | volume = 26 | issue = 1 | pages = 38–39 | year = 2002 | pmid = 11950200 | url = https://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-2002-cdi2601-cdi2601h.htm | url-status = dead | archive-url = https://web.archive.org/web/20140217035354/https://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-2002-cdi2601-cdi2601h.htm | archive-date = February 17, 2014 }}
</ref><ref name=sisaa>{{cite web| work = Centers for Disease Control and Prevention| title = Salmonella Infection (salmonellosis) and Animals| access-date = August 12, 2007| url = https://www.cdc.gov/healthypets/diseases/salmonellosis.htm| archive-url = https://web.archive.org/web/20070704172311/http://www.cdc.gov/healthypets/diseases/salmonellosis.htm| archive-date = July 4, 2007| url-status = dead}}</ref><ref name=rcfp>{{cite journal | vauthors = Doyle MP, Erickson MC | title = Reducing the carriage of foodborne pathogens in livestock and poultry | journal = Poultry Science | volume = 85 | issue = 6 | pages = 960–973 | date = June 2006 | pmid = 16776463 | doi = 10.1093/ps/85.6.960 | doi-access = free }}</ref>
* ''[[Medicine:Escherichia coli O157:H7]]'' enterohemorrhagic (EHEC) which can cause [[Medicine:Hemolytic-uremic syndrome|hemolytic-uremic syndrome]]

Other common bacterial foodborne pathogens are:<ref>{{cite web|url=https://www.cdc.gov/foodsafety/foodborne-germs.html | author = CDC | title = Foodborne Germs and Illnesses| date = March 18, 2020}}</ref>
* ''[[Biology:Bacillus cereus|Bacillus cereus]]''
* ''[[Biology:Escherichia coli|Escherichia coli]]'', other virulence properties, such as enteroinvasive (EIEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroaggregative (EAEC or EAgEC)
* ''[[Biology:Listeria monocytogenes|Listeria monocytogenes]]''
* ''[[Biology:Shigella|Shigella]]'' spp.
* ''[[Medicine:Staphylococcus aureus|Staphylococcus aureus]]''
* ''[[Biology:Streptococcus|Streptococcus]]''
* ''[[Biology:Vibrio cholerae|Vibrio cholerae]]'', including O1 and non-O1
* ''[[Biology:Vibrio parahaemolyticus|Vibrio parahaemolyticus]]''
* ''[[Biology:Vibrio vulnificus|Vibrio vulnificus]]''
* ''[[Biology:Yersinia enterocolitica|Yersinia enterocolitica]]'' and ''[[Medicine:Yersinia pseudotuberculosis|Yersinia pseudotuberculosis]]''

* ''[[Biology:Brucella|Brucella]]'' spp.
* ''[[Biology:Corynebacterium ulcerans|Corynebacterium ulcerans]]''
* ''[[Medicine:Q fever|Coxiella burnetii]]'' or Q fever
* ''[[Biology:Plesiomonas shigelloides|Plesiomonas shigelloides]]''

==== Enterotoxins ====
{{see also|Medicine:Botulism}}

In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by [[Biology:Enterotoxin|enterotoxin]]s ([[Biology:Exotoxin|exotoxin]]s targeting the intestines). Enterotoxins can produce illness even when the microbes that produced them have been killed. Symptom onset varies with the toxin but may be rapid in onset, as in the case of enterotoxins of ''[[Medicine:Staphylococcus aureus|Staphylococcus aureus]]'' in which symptoms appear in one to six hours.<ref>[http://www.mayoclinic.com/health/food-poisoning/DS00981/DSECTION=causes Food poisoning: Causes]. Mayo Clinic.</ref> This causes intense [[Medicine:Vomiting|vomiting]] including or not including diarrhea (resulting in [[Medicine:Staphylococcal enteritis|staphylococcal enteritis]]), and staphylococcal enterotoxins (most commonly staphylococcal enterotoxin A but also including staphylococcal enterotoxin B) are the most commonly reported enterotoxins although cases of poisoning are likely underestimated.<ref name=Staph>{{cite journal | vauthors = Argudín MÁ, Mendoza MC, Rodicio MR | title = Food poisoning and Staphylococcus aureus enterotoxins | journal = Toxins | volume = 2 | issue = 7 | pages = 1751–1773 | date = July 2010 | pmid = 22069659 | pmc = 3153270 | doi = 10.3390/toxins2071751 | doi-access = free }}</ref> It occurs mainly in cooked and processed foods due to competition with other biota in raw foods, and humans are the main cause of contamination as a substantial percentage of humans are persistent carriers of ''S.&nbsp;aureus''.<ref name=Staph/> The CDC has estimated about 240,000 cases per year in the United States.<ref>[http://ohioline.osu.edu/hyg-fact/5000/pdf/5564.pdf Staphylococcus aureus: A Problem When Food Is Left Out Too Long]. Ohio State University Extension HYG-5564-11].</ref>
* ''[[Biology:Clostridium botulinum|Clostridium botulinum]]''
* ''[[Biology:Clostridium perfringens|Clostridium perfringens]]''
* ''[[Biology:Bacillus cereus|Bacillus cereus]]''

The rare but potentially deadly disease [[Medicine:Botulism|botulism]] occurs when the [[Biology:Anaerobic organism|anaerobic]] bacterium ''[[Biology:Clostridium botulinum|Clostridium botulinum]]'' grows in improperly canned low-acid foods and produces botulin, a powerful paralytic toxin.{{cn|date=August 2023}}


====Emerging foodborne pathogens====
* ''[[Biology:Aeromonas hydrophila|Aeromonas hydrophila]]'', ''Aeromonas caviae'', ''Aeromonas sobria''
Scandinavian outbreaks of ''[[Biology:Yersinia enterocolitica|Yersinia enterocolitica]]'' have recently increased to an annual basis, connected to the non-canonical contamination of pre-washed salad.<ref>{{cite journal | vauthors = Karlsson PA, Tano E, Jernberg C, Hickman RA, Guy L, Järhult JD, Wang H | title = Molecular Characterization of Multidrug-Resistant ''Yersinia enterocolitica'' From Foodborne Outbreaks in Sweden | journal = Frontiers in Microbiology | volume = 12 | pages = 664665 | date = 2021-05-13 | pmid = 34054769 | pmc = 8155512 | doi = 10.3389/fmicb.2021.664665 | doi-access = free }}</ref>

====Preventing bacterial food poisoning====
[[File:Kingfish great south bay.jpg|thumb|Proper storage and [[refrigeration]] of food help in the prevention of food poisoning.]]Goverments have the primary mandate of ensuring safe food for all, however all actors in the food chain are responsible to ensure only safe food reaches the consumer, thus preventing foodborne illnesses. This is achieved through the implementation of strict hygiene rules and a public veterinary and phytosanitary service that monitors animal products throughout the food chain, from farming to delivery in shops and restaurants. This regulation includes:
* [[Traceability|traceability]]: the origin of the ingredients (farm of origin, identification of the crop or animal) and where and when it has been processed must be known in the final product; in this way, the origin of the disease can be traced and resolved (and possibly penalized), and the final products can be removed from sale if a problem is detected;
* enforcement of hygiene procedures such as HACCP and the "[[Physics:Cold chain|cold chain]]";
* power of control and of law enforcement of veterinarians.

In August 2006, the United States [[Organization:Food and Drug Administration|Food and Drug Administration]] approved [[Medicine:Phage therapy|phage therapy]] which involves spraying meat with viruses that infect bacteria, and thus preventing infection. This has raised concerns because without [[Social:Mandatory labelling|mandatory labeling]], consumers would not know that meat and poultry products have been treated with the spray.<ref>{{cite news| url=https://www.forbes.com/business/healthcare/feeds/ap/2006/08/18/ap2959720.html |title=FDA Says Viruses Safe for Treating Meat |archive-url=https://web.archive.org/web/20060825040502/http://www.forbes.com/business/healthcare/feeds/ap/2006/08/18/ap2959720.html|archive-date=August 25, 2006|access-date=September 2, 2014}}</ref>

At home, prevention mainly consists of good food safety practices. Many forms of bacterial poisoning can be prevented by cooking food sufficiently, and either eating it quickly or refrigerating it effectively.<ref name=CDC/> Many toxins, however, are not destroyed by heat treatment.

Techniques that help prevent food borne illness in the kitchen are hand washing, rinsing produce,<ref>{{Cite web|url=http://minnesota.cbslocal.com/2010/11/09/good-question-does-washing-fruit-do-anything/|title=Good Question: Does Washing Fruit Do Anything? |last=DeRusha |first=Jason | name-list-style = vanc |access-date=2016-09-18|date=2010-11-09}}</ref> preventing cross-contamination, proper storage, and maintaining cooking temperatures. In general, freezing or refrigerating prevents virtually all bacteria from growing, and heating food sufficiently kills parasites, viruses, and most bacteria. Bacteria grow most rapidly at the range of temperatures between {{convert|40|and|140|°F|°C}}, called the "danger zone". Storing food below or above the "danger zone" can effectively limit the production of toxins. For storing leftovers, the food must be put in shallow containers
for quick cooling and must be refrigerated within two hours. When food is reheated, it must reach an internal temperature of {{convert|165|F|C}} or until hot or steaming to kill bacteria.<ref>[http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/how-temperatures-affect-food/ct_index How Temperatures Affect Food]. U.D. Department of Agriculture</ref>

=== Mycotoxins and alimentary mycotoxicoses ===
The term alimentary mycotoxicosis refers to the effect of poisoning by [[Chemistry:Mycotoxin|mycotoxin]]s through food consumption.  The term mycotoxin is usually reserved for the toxic chemical  compounds naturally produced by fungi that readily colonize crops under given temperature and moisture conditions. Mycotoxins can have important effects on human and animal health.  For example, an outbreak which occurred in the UK during 1960 caused the death of 100,000 turkeys which had consumed [[Chemistry:Aflatoxin|aflatoxin]]-contaminated peanut meal. In the USSR in [[Social:World War II|World War II]], 5,000 people died due to [[Medicine:Alimentary toxic aleukia|alimentary toxic aleukia]] (ALA).<ref name=fam>{{cite web| last = Mount| first = Michael | name-list-style = vanc | title = Fungi and Mycotoxins| publisher = vetmed.ucdavis.edu| access-date = August 11, 2007| url = http://www.vetmed.ucdavis.edu/PHR/PHR250/2007/25007Myc.pdf| archive-url = https://web.archive.org/web/20070927001355/http://www.vetmed.ucdavis.edu/PHR/PHR250/2007/25007Myc.pdf| archive-date = September 27, 2007| url-status = dead}}</ref>. In Kenya, mycotoxins led to the death of 125 people in 2004, after consumption of contaminated grains.<ref>{{cite web | url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5334a4.htm | title=Outbreak of Aflatoxin Poisoning --- Eastern and Central Provinces, Kenya, January--July 2004 }}</ref> In animals, mycotoxicosis targets organ systems such as liver and digestive system. Other effects can include reduced productivity and suppression of the immune system, thus pre-disposing the animals to other secondary infections.<ref>{{cite journal | doi=10.3390/pr9112035 | doi-access=free | title=Mycotoxins—Prevention, Detection, Impact on Animal Health | date=2021 | last1=Kępińska-Pacelik | first1=Jagoda | last2=Biel | first2=Wioletta | journal=Processes | volume=9 | issue=11 | page=2035 }}</ref>
The common foodborne Mycotoxins include:
* [[Chemistry:Aflatoxin|Aflatoxin]]s – originating from ''[[Biology:Aspergillus parasiticus|Aspergillus parasiticus]]'' and ''[[Biology:Aspergillus flavus|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 [[Biology:Necrosis|necrosis]], [[Medicine:Cirrhosis|cirrhosis]], and [[Medicine:Carcinoma|carcinoma]]. Other forms of aflatoxins exist as [[Biology:Metabolite|metabolites]] such as Aflatoxin M1.<ref name=afltx>
{{cite web| work= Center for Food Safety & Applied Nutrition| title = Aflatoxins | access-date = August 12, 2007| url = https://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm071020.htm}}</ref><ref name="gtlmg">{{cite web|url=http://www.fao.org/Wairdocs/X5008E/X5008e01.htm|title=GASGA Technical Leaflet – 3 Mycotoxins in Grain|work=Food and Agriculture Organization of the United Nations|archive-url=https://web.archive.org/web/20170112143005/http://www.fao.org/Wairdocs/X5008E/X5008e01.htm|archive-date=January 12, 2017|access-date=August 12, 2007}}</ref> In the US, the acceptable level of total aflatoxins in foods is less than 20''&nbsp;''μg/kg, except for Aflatoxin M1 in milk, which should be less than 0.5''&nbsp;''μg/kg The official document can be found at [[Organization:Food and Drug Administration|FDA]]'s website.<ref name=sec683100>{{cite web| work = Food and Drug Administration| title = Sec. 683.100 Action Levels for Aflatoxins in Animal Feeds (CPG 7126.33) | access-date = August 13, 2007| url = https://www.fda.gov/ora/compliance_ref/cpg/cpgvet/cpg683-100.html}}</ref><ref name=mfcvmp>{{cite web| last = Henry| first = Michael H. | name-list-style = vanc | title = Mycotoxins in Feeds: CVM's Perspective|work=FDA.gov| access-date = January 1, 2012| url = https://www.fda.gov/AnimalVeterinary/Products/AnimalFoodFeeds/Contaminants/ucm050974.htm}}</ref> The European union has more stringent standards, set at 10 μg/kg in cereals and cereal products. These references are also adopted in other countries.<ref>{{cite journal | doi=10.2903/sp.efsa.2013.EN-406 | title=Aflatoxins (Sum of B1, B2, G1, G2) in cereals and cereal-derived food products | journal=EFSA Supporting Publications | date=2013 | volume=10 | issue=3 | doi-access=free }}</ref><ref name=cfh>
{{cite web| work = World Health Organization| title = Chapter 2 Foodborne Hazards in ''Basic Food Safety for Health Workers'' | access-date = August 12, 2007| url =https://www.who.int/entity/foodsafety/publications/capacity/en/2.pdf| archive-url =https://wayback.archive-it.org/all/20070927001355/http://www.who.int/entity/foodsafety/publications/capacity/en/2.pdf| url-status =dead| archive-date =September 27, 2007}}</ref> 
* Altertoxins – are those of [[Chemistry:Alternariol|alternariol]] (AOH), alternariol methyl ether (AME), altenuene (ALT), altertoxin-1 (ATX-1), [[Chemistry:Tenuazonic acid|tenuazonic acid]] (TeA), and [[Chemistry:Radicinin|radicinin]] (RAD), originating from ''[[Biology:Alternaria|Alternaria]]'' spp. Some of the toxins can be present in sorghum, ragi, wheat and tomatoes.<ref name=atwdw>
{{cite journal |vauthors=Webley DJ, Jackson KL, Mullins JD, Hocking AD, Pitt JI |title=''Alternaria'' toxins in weather-damaged wheat and sorghum in the 1995–1996 Australian harvest |journal=Australian Journal of Agricultural Research |volume=48 |issue=8 |pages=1249–56 |year=1997 |doi=10.1071/A97005  }}</ref><ref name=amwwc>{{cite journal | vauthors = Li FQ, Yoshizawa T | title = Alternaria mycotoxins in weathered wheat from China | journal = Journal of Agricultural and Food Chemistry | volume = 48 | issue = 7 | pages = 2920–2924 | date = July 2000 | pmid = 10898645 | doi = 10.1021/jf0000171 }}</ref><ref name=sbtp>{{cite journal | vauthors = Motta SD, Valente Soares LM | title = Survey of Brazilian tomato products for alternariol, alternariol monomethyl ether, tenuazonic acid and cyclopiazonic acid | journal = Food Additives and Contaminants | volume = 18 | issue = 7 | pages = 630–634 | date = July 2001 | pmid = 11469319 | doi = 10.1080/02652030117707 | s2cid = 45938351 }}</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 journal | vauthors = Li FQ, Toyazaki N, Yoshizawa T | title = Production of alternaria mycotoxins by Alternaria alternata isolated from weather-damaged wheat | journal = Journal of Food Protection | volume = 64 | issue = 4 | pages = 567–571 | date = April 2001 | pmid = 11307900 | doi = 10.4315/0362-028X-64.4.567 | doi-access = free }}
</ref>
* [[Chemistry:Citrinin|Citrinin]]
* [[Chemistry:Citreoviridin|Citreoviridin]]
* [[Chemistry:Cyclopiazonic acid|Cyclopiazonic acid]]
* [[Chemistry:Cytochalasin|Cytochalasin]]s
* Ergot alkaloids / ergopeptine alkaloids – [[Chemistry:Ergotamine|ergotamine]]
* [[Chemistry:Fumonisin|Fumonisin]]s – Crop corn can be easily contaminated by the fungi ''Fusarium moniliforme'', and its [[Chemistry:Fumonisin B1|fumonisin B1]] will cause leukoencephalomalacia (LEM) in horses, pulmonary edema syndrome (PES) in pigs, liver cancer in rats and [[Medicine:Esophageal cancer|esophageal cancer]] in humans.<ref name=ftihah>{{cite journal | vauthors = Marasas WF | title = Fumonisins: their implications for human and animal health | journal = Natural Toxins | volume = 3 | issue = 4 | pages = 193–8; discussion 221 | year = 1995 | pmid = 7582616 | doi = 10.1002/nt.2620030405 }}</ref><ref name=off>{{cite journal |doi=10.1016/j.foodres.2004.06.009 | title=Occurrence of fumonisins in foods | journal=Food Research International | date=2004 | volume=37 | issue=10 | pages=985–1000 | vauthors = Soriano JM }}</ref> For human and animal health, both the [[Organization: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| work = Food and Drug Administration| title = CVM and Fumonisins | access-date = August 13, 2007| url = https://www.fda.gov/cvm/fumonisin.htm |archive-url = https://web.archive.org/web/20070812000712/https://www.fda.gov/cvm/fumonisin.htm <!-- Bot retrieved archive --> |archive-date = August 12, 2007}}</ref><ref name=mcmmp>{{cite web| work = Food Standards Agency| title = More contaminated maize meal products withdrawn from sale| access-date = August 12, 2007| url = http://www.food.gov.uk/news/newsarchive/2003/sep/moremaize| archive-date = August 13, 2007| archive-url = https://web.archive.org/web/20070813075444/http://www.food.gov.uk/news/newsarchive/2003/sep/moremaize| url-status = dead}}</ref>
* [[Chemistry:Fusaric acid|Fusaric acid]]
* Fusarochromanone
* [[Chemistry:Kojic acid|Kojic acid]]
* Lolitrem alkaloids
* [[Chemistry:Moniliformin|Moniliformin]]
* 3-Nitropropionic acid
* [[Chemistry:Nivalenol|Nivalenol]]
* [[Biology:Ochratoxin|Ochratoxin]]s – In Australia, The Limit of Reporting (LOR) level for [[Chemistry:Ochratoxin A|ochratoxin A]] (OTA) analyses in 20th Australian Total Diet Survey was 1&nbsp;μg/kg,<ref name=2atds>{{cite web| work = Food Standards Australia New Zealand| title = 20th Australian Total Diet Survey – Part B| access-date = August 13, 2007| url = http://www.foodstandards.gov.au/newsroom/publications/20thaustraliantotaldietsurveyjanuary2003/20thaustraliantotaldietsurveyfullreport/partb20thatds/partbmetals.cfm| archive-url = https://web.archive.org/web/20070902112319/http://www.foodstandards.gov.au/newsroom/publications/20thaustraliantotaldietsurveyjanuary2003/20thaustraliantotaldietsurveyfullreport/partb20thatds/partbmetals.cfm| archive-date = September 2, 2007| url-status = dead}}</ref> whereas the EC restricts the content of OTA to 5&nbsp;μg/kg in cereal commodities, 3&nbsp;μg/kg in processed products and 10&nbsp;μg/kg in dried vine fruits.<ref name=wrmff>{{cite web| work = FAO FOOD AND NUTRITION PAPER 81| title =  Worldwide regulations for mycotoxins in food and feed in 2003 | access-date = August 13, 2007| url = http://www.fao.org/docrep/007/y5499e/y5499e0f.htm}}</ref>
* Oosporeine
* [[Chemistry:Patulin|Patulin]] – Currently, this toxin has been advisably regulated on fruit products.  The EC and the [[Organization:Food and Drug Administration|FDA]] have limited it to under 50&nbsp;μg/kg for fruit juice and fruit nectar, while limits of 25&nbsp;μg/kg for solid-contained fruit products and 10&nbsp;μg/kg for baby foods were specified by the EC.<ref name="wrmff"/><ref name=pajajc>{{cite web| work = Food and Drug Administration| title = Patulin in Apple Juice, Apple Juice Concentrates and Apple Juice Products| access-date = August 16, 2007| url = http://vm.cfsan.fda.gov/~dms/patubckg.html| archive-url = https://web.archive.org/web/20070912062502/http://vm.cfsan.fda.gov/~dms/patubckg.html| archive-date = September 12, 2007| url-status = dead}}</ref>
* Phomopsins
* Sporidesmin A
* [[Chemistry:Sterigmatocystin|Sterigmatocystin]]
* Tremorgenic mycotoxins – Five of them have been reported to be associated with molds found in fermented meats. These are fumitremorgen B, [[Chemistry:Paxilline|paxilline]], [[Chemistry:Penitrem A|penitrem A]], [[Chemistry:Verrucosidin|verrucosidin]], and [[Chemistry:Verruculogen|verruculogen]].<ref name=gaftm>{{cite journal | vauthors = Sabater-Vilar M, Nijmeijer S, Fink-Gremmels J | title = Genotoxicity assessment of five tremorgenic mycotoxins (fumitremorgen B, paxilline, penitrem A, verruculogen, and verrucosidin) produced by molds isolated from fermented meats | journal = Journal of Food Protection | volume = 66 | issue = 11 | pages = 2123–2129 | date = November 2003 | pmid = 14627292 | doi = 10.4315/0362-028X-66.11.2123 | doi-access = free }}</ref>
* [[Chemistry:Trichothecene|Trichothecene]]s – sourced from ''Cephalosporium'', ''[[Biology:Fusarium|Fusarium]]'', ''Myrothecium'', ''[[Biology:Stachybotrys|Stachybotrys]]'', and ''[[Biology:Trichoderma|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 journal | vauthors = Adejumo TO, Hettwer U, Karlovsky P | title = Occurrence of Fusarium species and trichothecenes in Nigerian maize | journal = International Journal of Food Microbiology | volume = 116 | issue = 3 | pages = 350–357 | date = May 2007 | pmid = 17412440 | doi = 10.1016/j.ijfoodmicro.2007.02.009 }}</ref><ref name=snhe>
{{cite journal | vauthors = Mazur LJ, Kim J | title = Spectrum of noninfectious health effects from molds | journal = Pediatrics | volume = 118 | issue = 6 | pages = e1909–e1926 | date = December 2006 | pmid = 17142508 | doi = 10.1542/peds.2006-2829 | doi-access = free }}</ref> Four trichothecenes, T-2 toxin, HT-2 toxin, [[Chemistry:Diacetoxyscirpenol|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, [[Medicine:Neutropenia|neutropenia]], [[Medicine:Aplastic anemia|aplastic anemia]], [[Medicine:Thrombocytopenia|thrombocytopenia]] and/or skin irritation.<ref name=tthm>{{cite journal | vauthors = Froquet R, Sibiril Y, Parent-Massin D | title = Trichothecene toxicity on human megakaryocyte progenitors (CFU-MK) | journal = Human & Experimental Toxicology | volume = 20 | issue = 2 | pages = 84–89 | date = February 2001 | pmid = 11327514 | doi = 10.1191/096032701677428611 | bibcode = 2001HETox..20...84F | s2cid = 37767457 }}</ref><ref name=csytt>{{cite journal | vauthors = Joffe AZ, Yagen B | 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 | journal = Mycopathologia | volume = 60 | issue = 2 | pages = 93–97 | date = February 1977 | pmid = 846559 | doi = 10.1007/bf00490378 | s2cid = 39431820 }}</ref><ref name=fis>{{cite journal | vauthors = Hay RJ | title = Fusarium infections of the skin | journal = Current Opinion in Infectious Diseases | volume = 20 | issue = 2 | pages = 115–117 | date = April 2007 | pmid = 17496567 | doi = 10.1097/QCO.0b013e328014392d }}</ref> In 1993, the [[Organization: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| work = Food and Drug Administration| title = Guidance for Industry and FDA – Letter to State Agricultural Directors, State Feed Control Officials, and Food, Feed, and Grain Trade Organizations | access-date = August 13, 2007| url = http://www.cfsan.fda.gov/~dms/graingui.html |archive-url = https://web.archive.org/web/20070609034256/http://www.cfsan.fda.gov/~dms/graingui.html <!-- Bot retrieved archive --> |archive-date = June 9, 2007}}</ref> In 2003, US published a patent that is very promising for farmers to produce a trichothecene-resistant crop.<ref name=trtp>Hohn, Thomas M. "Trichothecene-resistant transgenic plants". {{US Patent|6646184}}. Priority date March 31, 1999.</ref>
* [[Chemistry:Zearalenone|Zearalenone]]
* Zearalenols

===Viruses===
* [[Biology:Enterovirus|Enterovirus]]
* [[Medicine:Hepatitis A|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 [[Biology:Liver|liver]]. It often results in [[Medicine:Jaundice|jaundice]], or yellowing of the skin, but rarely leads to chronic liver dysfunction. The virus has been found to cause infection due to the consumption of fresh-cut produce which has fecal contamination.<ref name=ivcma>
{{cite journal | vauthors = Dubois E, Hennechart C, Deboosère N, Merle G, Legeay O, Burger C, Le Calvé M, Lombard B, Ferré V, Traoré O | display-authors = 6 | 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 | journal = International Journal of Food Microbiology | volume = 108 | issue = 2 | pages = 164–171 | date = April 2006 | pmid = 16387377 | doi = 10.1016/j.ijfoodmicro.2005.11.007 }}
</ref><ref name=imqsf>{{cite thesis | last = Schmidt| first = Heather Martin | name-list-style = vanc | title = Improving the microbiological quality and safety of fresh-cut tomatoes by low dose electron beam irradiation |type=MS thesis |publisher=Texas A&M University |date=2004 | access-date = December 14, 2022| url =https://oaktrust.library.tamu.edu/handle/1969.1/2767 |hdl=1969.1/2767}}</ref>
* [[Medicine:Hepatitis E|Hepatitis E]]
* [[Medicine:Norovirus|Norovirus]]
* [[Biology:Rotavirus|Rotavirus]] [[File:Rotavirus.jpg|right|200px|thumb|Rotavirus]]

===Parasites===
Most foodborne [[Biology:Parasite|parasite]]s are [[Biology:Zoonosis|zoonoses]].<ref>{{cite journal | vauthors = Murrell KD | title = Zoonotic foodborne parasites and their surveillance | journal = Revue Scientifique et Technique | volume = 32 | issue = 2 | pages = 559–569 | date = August 2013 | pmid = 24547659 | doi = 10.20506/rst.32.2.2239 | doi-access = free }}</ref>
** ''[[Biology:Diphyllobothrium|Diphyllobothrium]]'' sp.
** ''Nanophyetus'' sp.
** ''[[Biology:Taenia saginata|Taenia saginata]]''
** ''[[Biology:Taenia solium|Taenia solium]]''
** ''[[Biology:Fasciola hepatica|Fasciola hepatica]]''
** See also: Tapeworm and [[Biology:Flatworm|Flatworm]]
* [[Biology:Nematode|Nematode]]:<ref>{{Cite web| url= https://www.britannica.com/animal/nematode| author=Britannica | title= Nematode| date = 2021}}</ref>
** ''[[Medicine:Anisakis|Anisakis]]'' sp.
** ''[[Biology:Ascaris lumbricoides|Ascaris lumbricoides]]''
** ''Eustrongylides'' sp.
** ''Toxocara''
** ''[[Biology:Trichinella spiralis|Trichinella spiralis]]''
** ''[[Biology:Trichuris trichiura|Trichuris trichiura]]''
** ''[[Biology:Acanthamoeba|Acanthamoeba]]'' and other free-living [[Biology:Amoeba|amoeba]]e
** ''[[Medicine:Cryptosporidiosis|Cryptosporidiosis]]''
** ''[[Biology:Cyclospora cayetanensis|Cyclospora cayetanensis]]''
** ''[[Biology:Entamoeba histolytica|Entamoeba histolytica]]''
** ''[[Biology:Giardia lamblia|Giardia lamblia]]''[[File:Giardia lamblia.jpg|right|200px|thumb|''Giardia lamblia'']]
** ''Sarcocystis hominis''
** ''Sarcocystis suihominis''
** ''[[Biology:Toxoplasma|Toxoplasma]]''

===Natural toxins===
* [[Chemistry:Alkaloid|Alkaloid]]s
* Ciguatera poisoning
* [[Biology:Grayanotoxin|Grayanotoxin]] ([[Chemistry:Honey|honey]] intoxication)
* Hormones from the thyroid glands of slaughtered animals (especially [[Chemistry:Triiodothyronine|triiodothyronine]] in cases of ''hamburger thyrotoxicosis'' or ''alimentary thyrotoxicosis'')<ref>{{cite journal | vauthors = Wartique L, Pothen L, Pirson N, Hermans MP, Lambert M, Yildiz H | title = An unusual cause of epidemic thyrotoxicosis | journal = Acta Clinica Belgica | volume = 72 | issue = 6 | pages = 451–453 | date = December 2017 | pmid = 28361645 | doi = 10.1080/17843286.2017.1309336 | s2cid = 24489342 }}</ref><ref name="pmid3561455">{{cite journal | vauthors = Hedberg CW, Fishbein DB, Janssen RS, Meyers B, McMillen JM, MacDonald KL, White KE, Huss LJ, Hurwitz ES, Farhie JR | display-authors = 6 | title = An outbreak of thyrotoxicosis caused by the consumption of bovine thyroid gland in ground beef | journal = The New England Journal of Medicine | volume = 316 | issue = 16 | pages = 993–998 | date = April 1987 | pmid = 3561455 | doi = 10.1056/NEJM198704163161605 }}</ref><ref name="pmid12952802">{{cite journal | vauthors = Parmar MS, Sturge C | title = Recurrent hamburger thyrotoxicosis | journal = CMAJ | volume = 169 | issue = 5 | pages = 415–417 | date = September 2003 | pmid = 12952802 | pmc = 183292 }}</ref><ref name="pmid25517332">{{cite journal | vauthors = Broome MR, Peterson ME, Kemppainen RJ, Parker VJ, Richter KP | title = Exogenous thyrotoxicosis in dogs attributable to consumption of all-meat commercial dog food or treats containing excessive thyroid hormone: 14 cases (2008-2013) | journal = Journal of the American Veterinary Medical Association | volume = 246 | issue = 1 | pages = 105–111 | date = January 2015 | pmid = 25517332 | doi = 10.2460/javma.246.1.105 | doi-access = free }}</ref><ref name="pmid20308711">{{cite journal | vauthors = Hendriks LE, Looij BJ | title = Hyperthyroidism caused by excessive consumption of sausages | journal = The Netherlands Journal of Medicine | volume = 68 | issue = 3 | pages = 135–137 | date = March 2010 | pmid = 20308711 }}</ref><ref name="pmid3257352">{{cite journal | vauthors = Kinney JS, Hurwitz ES, Fishbein DB, Woolf PD, Pinsky PF, Lawrence DN, Anderson LJ, Holmes GP, Wilson CK, Loschen DJ | display-authors = 6 | title = Community outbreak of thyrotoxicosis: epidemiology, immunogenetic characteristics, and long-term outcome | journal = The American Journal of Medicine | volume = 84 | issue = 1 | pages = 10–18 | date = January 1988 | pmid = 3257352 | doi = 10.1016/0002-9343(88)90002-2 }}</ref>
* [[Medicine:Mushroom poisoning|Mushroom toxins]]
* [[Biology:Phytohaemagglutinin|Phytohaemagglutinin]] (red [[Biology:Kidney bean|kidney bean]] poisoning; destroyed by boiling)
* [[Biology:Pyrrolizidine alkaloid|Pyrrolizidine alkaloid]]s
* Shellfish toxin, including [[Medicine:Paralytic shellfish poisoning|paralytic shellfish poisoning]], diarrhetic shellfish poisoning, neurotoxic shellfish poisoning, [[Chemistry:Domoic acid|amnesic shellfish poisoning]] and ciguatera fish poisoning
* Scombrotoxin
* [[Chemistry:Solanine|Solanine]] (green [[Biology:Potato|potato]] poisoning)
* [[Chemistry:Tetrodotoxin|Tetrodotoxin]] (fugu fish poisoning)

Some plants contain substances which are toxic in large doses, but have therapeutic properties in appropriate dosages.
* Foxglove contains cardiac glycosides.

===Other pathogenic agents===
* [[Medicine:Prion|Prion]]s, resulting in [[Medicine:Creutzfeldt–Jakob disease|Creutzfeldt–Jakob disease]] (CJD) and its variant ([[Medicine:Variant Creutzfeldt–Jakob disease|vCJD]])

==="Ptomaine poisoning" misconception {{anchor|ptomaine}}===
Ptomaine poisoning was a myth that persisted in the public consciousness, in newspaper headlines, and legal cases as an official diagnosis, decades after it had been scientifically disproven in the 1910s.<ref>{{cite magazine|magazine=The Spectator|title=The Ptomaine-Poisoning Myth|date=1934-05-25|author1-first=W. A.|author1-last=Brend|url=http://archive.spectator.co.uk/article/25th-may-1934/9/the-ptomaine-poisoning-myth}}</ref>

In the 19th century, the Italian chemist Francesco Selmi, of Bologna, introduced the generic name ''{{linktext|ptomaine}}'' (from Greek ''ptōma'',  "fall, fallen body, corpse") for [[Chemistry:Alkaloid|alkaloid]]s found in decaying animal and vegetable matter, especially (as reflected in their names) [[Chemistry:Putrescine|putrescine]] and [[Chemistry:Cadaverine|cadaverine]].<ref name="oed"
>{{cite book|title=Oxford English Dictionary|date=1933|publisher=Oxford University Press|location=London|page=1557|edition=First}}</ref>  The 1892 ''Merck's Bulletin'' stated, "We name such products of bacterial origin ptomaines; and the special [[Chemistry:Alkaloid|alkaloid]] produced by the [[Biology:Vibrio|comma bacillus]] is variously named Cadaverine, Putrescine, etc."<ref>[https://books.google.com/books?id=uEBYAAAAMAAJ ''Merck's Bulletin'', Volume 5], William Henry Porter, 1892.</ref> While ''The Lancet'' stated, "The chemical ferments produced in the system, the... ptomaines which may exercise so disastrous an influence."<ref>Lancet, 3 Oct 1891, page 752</ref> It is now known that the "disastrous... influence" is due to the direct action of [[Biology:Bacteria|bacteria]] and only slightly due to the alkaloids. Thus, the use of the phrase "ptomaine poisoning" is now largely obsolete.{{cn|date=August 2023}}

At a Communist political convention in Massillon, Ohio,<ref>[https://www.newspapers.com/image/10618541/ "Report Next Week,"] ''Evening Independent'' (Massillon, OH), July 22, 1932, pg. 6</ref> and aboard a cruise ship in Washington, D.C., tainted potato salad sickened hundreds in separate incidents during a single week in 1932, drawing national attention to the dangers of so-called "ptomaine poisoning" in the pages of the American news weekly, ''Time.''<ref>"Medicine: Potato Salad," ''Time,'' August 1, 1932.</ref> In 1944, another newspaper article reported that over 150 people in Chicago were hospitalized with ptomaine poisoning, apparently from rice pudding served by a restaurant chain.<ref>{{cite news|title=Poisoning Hits 150 in Chicago|url=http://ken.stparchive.com/Archive/KEN/KEN05271944p01.php|work=Kenosha Evening News|date=May 27, 1944|access-date=March 9, 2015|archive-date=April 27, 2021|archive-url=https://web.archive.org/web/20210427133354/http://ken.stparchive.com/Archive/KEN/KEN05271944p01.php|url-status=dead}}</ref>

==Mechanism==

===Incubation period===
The delay between the consumption of contaminated food and the appearance of the first [[Medicine:Symptom|symptom]]s of illness is called the [[Medicine:Incubation period|incubation period]]. This ranges from hours to days (and rarely months or even years, such as in the case of [[Medicine:Listeriosis|listeriosis]] or [[Medicine:Bovine spongiform encephalopathy|bovine spongiform encephalopathy]]), depending on the agent, and on how much was consumed. If symptoms occur within one to six hours after eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than live bacteria.{{cn|date=August 2023}}

The long incubation period of many foodborne illnesses tends to cause those affected to attribute their symptoms to [[Medicine:Gastroenteritis|gastroenteritis]].<ref>{{cite journal | vauthors = Lee RM, Lessler J, Lee RA, Rudolph KE, Reich NG, Perl TM, Cummings DA | title = Incubation periods of viral gastroenteritis: a systematic review | journal = BMC Infectious Diseases | volume = 13 | pages = 446 | date = September 2013 | pmid = 24066865 | pmc = 3849296 | doi = 10.1186/1471-2334-13-446 | doi-access = free }}</ref>

During the incubation period, microbes pass through the [[Biology:Stomach|stomach]] into the [[Chemistry:Intestine|intestine]], attach to the [[Biology:Cell|cells]] lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a [[Biology:Toxin|toxin]] that is absorbed into the [[Biology:Blood|blood]]stream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe.<ref>
{{cite web|work=US Centers for Disease Control and Prevention|url=https://www.cdc.gov/ncidod/diseases/food/index.htm |title=Food-Related Diseases|date=2018-03-29 }}
</ref>

===Infectious dose===
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. Pathogens vary in minimum infectious dose; for example, ''[[Biology:Shigella sonnei|Shigella sonnei]]'' has a low estimated minimum dose of < 500 [[Biology:Colony-forming unit|colony-forming unit]]s (CFU) while ''[[Medicine:Staphylococcus aureus|Staphylococcus aureus]]'' has a relatively high estimate.<ref name=":0">{{Cite web |vauthors=Greig JD  |title=Infective Doses and Pathogen Carriage |url=https://www.researchgate.net/publication/265305465 |website=ResearchGate}}</ref>

In the case of ''[[Biology:Salmonella|Salmonella]]'' a relatively large inoculum of 1''&nbsp;''million to 1''&nbsp;''billion organisms is necessary to produce symptoms in healthy human volunteers,<ref>Owens, Michael D (January 2014) [http://www.emedicine.com/emerg/topic515.htm Salmonella Infection in Emergency Medicine]. emedicine.com</ref> as ''Salmonellae'' are very sensitive to acid. An unusually high stomach [[Chemistry:PH|pH]] level (low acidity) greatly reduces the number of bacteria required to cause symptoms by a factor of between 10 and 100.{{cn|date=August 2023}}

===Gut microbiota unaccustomed to endemic organisms===
Foodborne illness often occurs as [[Medicine:Travelers' diarrhea|travelers' diarrhea]] in persons whose [[Biology:Gut microbiota|gut microbiota]] is unaccustomed to organisms endemic to the visited region. This effect of microbiologic naïveté is compounded by any food safety lapses in the food's preparation.{{cn|date=August 2023}}

==Epidemiology==
Asymptomatic [[Medicine:Subclinical infection|subclinical infection]] may help spread these diseases, particularly ''[[Medicine:Staphylococcus aureus|Staphylococcus aureus]]'', ''[[Biology:Campylobacter|Campylobacter]], [[Biology:Salmonella|Salmonella]], [[Biology:Shigella|Shigella]], [[Biology:Enterobacter|Enterobacter]], [[Biology:Vibrio cholerae|Vibrio cholerae]],'' and [[Biology:Yersinia pestis|''Yersinia'']].<ref name=":0" /> For example, as of 1984 it was estimated that in the United States, 200,000 people were asymptomatic carriers of ''Salmonella''.<ref name=":0" />

===Infants===
{{Main | Medicine:Infant food safety}}
Globally, infants are a group that is especially vulnerable to foodborne disease. The World Health Organization has issued recommendations for the preparation, use and storage of prepared formulas. Breastfeeding remains the best preventive measure for protection from foodborne infections in infants.<ref>{{cite web | url=https://www.who.int/foodsafety/publications/mra10/en/ | archive-url=https://web.archive.org/web/20150402090052/http://www.who.int/foodsafety/publications/mra10/en/ | url-status=dead | archive-date=April 2, 2015 | title=Enterobacter sakazakii and Salmonella in powdered infant formula | date=2006 | author=FAO/WHO | editor=World Health Organization | type=Meeting report | series=Microbiological risk assessment series 10}}</ref>

===United States===

A CDC report<ref>[https://www.cdc.gov/mmwr/volumes/72/ss/ss7206a1.htm?s_cid=ss7206a1_w Foodborne Illness Outbreaks at Retail Food Establishments — National Environmental Assessment Reporting System, 25 State and Local Health Departments, 2017–2019]</ref> for the period 2017–2019 found that 41% of outbreaks at restaurants were caused by a sick employee. Contributory factors identified included lack of written policy compliance with FDA recommendations for identifying red-flag symptoms, glove use, and hand washing; lack of paid sick leave at the majority of establishments; and social pressure to come to work even while sick.<ref>[https://www.washingtonpost.com/health/2023/05/31/food-poisoning-illness-sick-workers-cdc/ Food poisoning often caused by sick restaurant workers, CDC says]</ref> The remaining outbreaks had a variety of causes, including inadequate cooking, improper temperature, and cross-contamination{{cn|date=August 2023}}.

In the United States, using FoodNet data from 2000 to 2007, the CDC estimated there were 47.8''&nbsp;''million foodborne illnesses per year (16,000 cases for 100,000 inhabitants)<ref name=CDC11Unspec>{{cite journal | vauthors = Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM | title = Foodborne illness acquired in the United States--unspecified agents | journal = Emerging Infectious Diseases | volume = 17 | issue = 1 | pages = 16–22 | date = January 2011 | pmid = 21192849 | pmc = 3204615 | doi = 10.3201/eid1701.P21101 }}</ref> with 9.4''&nbsp;''million of these caused by 31 known identified pathogens.<ref name=CDC11Spec />

<!-- orphan reference: surely useful for some fact, just not these<ref>
{{cite web
 | url=https://www.who.int/mediacentre/factsheets/fs237/en/
 | archive-url=https://web.archive.org/web/20040227020759/http://www.who.int/mediacentre/factsheets/fs237/en/
 | url-status=dead
 | archive-date=February 27, 2004
 | title=Food safety and foodborne illness
 | publisher=WHO}}
</ref> -->
* 127,839 were hospitalized (43 per 100,000 inhabitants per year).<ref>{{cite news |title=Obama Proposes Single Overseer for Food Safety |url=https://www.nytimes.com/2015/02/21/us/obama-proposes-single-overseer-for-food-safety.html |quote=According to the C.D.C., an estimated 87 million Americans are sickened each year by contaminated food, 371,000 are hospitalized with food-related illness and 5,700 die from food-related disease |newspaper=The New York Times |date=February 20, 2015 |access-date=2015-02-22 }}</ref><ref name=six/><ref name=strom>{{cite news |author=Stephanie Strom |title=F.D.A. Offers Sweeping Rules to Fight Food Contamination |url=https://www.nytimes.com/2013/01/05/business/fda-offers-rules-to-stop-food-contamination.html |quote=One in six Americans becomes ill from eating contaminated food each year, the government estimates; of those, roughly 130,000 are hospitalized and 3,000 die. |newspaper=The New York Times |date=January 4, 2013 |access-date=January 5, 2013 |}}</ref>
* 3,037 people [[Biology:Death|died]] (1.0 per 100,000 inhabitants per year).<ref name=six>{{cite news |author=Sabrina Tavernise |title=F.D.A. Says Importers Must Audit Food Safety |url=https://www.nytimes.com/2013/07/27/health/fda-proposes-rules-to-ensure-safety-of-imported-food.html |quote=One in every six Americans becomes ill from eating contaminated food each year, Dr. Margaret A. Hamburg, F.D.A. commissioner, estimated. About 130,000 are hospitalized and 3,000 die. |newspaper=The New York Times |date=July 26, 2013 |access-date=July 27, 2013 |}}</ref><ref name=strom/>

{{Col-begin}}
{{Col-2}}
{|class="wikitable" style="font-size:95%"
|+ Causes of foodborne illness in US<ref name=CDC11Spec>{{cite journal | vauthors = Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM | display-authors = 6 | title = Foodborne illness acquired in the United States--major pathogens | journal = Emerging Infectious Diseases | volume = 17 | issue = 1 | pages = 7–15 | date = January 2011 | pmid = 21192848 | pmc = 3375761 | doi = 10.3201/eid1701.P11101 }}
</ref>
|-
! !! Cause !! Annual cases !! Rate<br /><small>(per 100,000 inhabitants)</small>
|-
| 1 || ''[[Medicine:Norovirus|Norovirus]]'' || 5,461,731 cases || align="center"|X
|-
| 2 || ''[[Biology:Salmonella|Salmonella]]'' || 1,027,561 cases || align="center"|X
|-
| 3 || ''[[Biology:Clostridium perfringens|Clostridium perfringens]]'' || 965,958 cases || align="center"|X
|-
| 4 || ''[[Biology:Campylobacter|Campylobacter]]'' || 845,024 cases || align="center"|X
|}
{{Col-2}}
{|class="wikitable" style="font-size:95%;"
|+ Causes of death by foodborne illness in US<ref name=CDC11Spec />
|-
! !! Cause !! Annual deaths!! Rate<br /><small>(per 100,000 inhabitants)</small>
|-
| 1 || ''[[Biology:Salmonella|Salmonella]]'' || 378 cases || align="center"| 0.126
|-
| 2 || ''[[Biology:Toxoplasma|Toxoplasma]]'' || 327 cases || align="center"| 0.109
|-
| 3 || ''[[Biology:Listeria|Listeria]]'' ||  255 cases || align="center"| 0.085
|-
| 4 || ''[[Medicine:Norovirus|Norovirus]]'' || 149 cases || align="center"| 0.050
|}
{{Col-end}}

=== United Kingdom ===

According to a 2012 report from the Food Standards Agency, there were around a million cases of foodborne illness per year (1,580 cases for 100,000 inhabitants).<ref name=":2">{{cite web | title =  Annual Report of the Chief Scientist 2012/13 | url = https://acss.food.gov.uk/sites/default/files/multimedia/pdfs/publication/cstar_2013.pdf | work = Food Standards Agency | location = England | date = 2013 }}</ref>
* 20,000 were hospitalized (32 per 100,000 inhabitants);<ref name=":2" /><ref name=":3">{{Cite book |url= https://books.google.com/books?id=iJjJDgAAQBAJ&pg=PA290 |title=The Oxford Handbook of Criminology |last1=Liebling |first1=Alison |last2=Maruna |first2=Shadd |last3=McAra |first3=Lesley | name-list-style = vanc |date=2017|publisher=Oxford University Press|isbn=978-0-19-871944-1|pages=290|language=en}}</ref>
* 500 people died (0.80 per 100,000 inhabitants).<ref name=":2" /><ref name=":3" />

===France===
This data pertains to reported medical cases of 23 specific pathogens in the 1990s, as opposed to total population estimates of all foodborne illness for the United States.<ref name=inf_origine_alimentaire>{{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=fr | access-date=October 6, 2004 | archive-date=March 3, 2016 | archive-url=https://web.archive.org/web/20160303221009/http://www.invs.sante.fr/publications/2004/inf_origine_alimentaire/inf_origine_alimentaire.pdf | url-status=dead }}</ref>

In France, for  735,590 to 769,615 cases of infection identified as being with the 23 specific pathogens, 238,836 to 269,085 were estimated to have been contracted from food:
* between  12,995 and 22,030 people were hospitalized (10,188 to 17,771 estimated to have contracted their infections from food);
*  between 306 and 797 people died (228 to 691 estimated to have contracted their infections from food).<ref name=inf_origine_alimentaire />

{{Col-begin}}
{{Col-2}}
{|class="wikitable" style="font-size:95%"
|+ Causes of foodborne illness in France<ref name=inf_origine_alimentaire /><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=fr | access-date=October 6, 2004 | archive-date=March 3, 2016 | archive-url=https://web.archive.org/web/20160303184200/http://www.invs.sante.fr/publications/2004/inf_origine_alimentaire/grilleLecture.pdf | url-status=dead }}</ref>
|-
! !! Cause !! Annual hospitalizations !! Rate<br /><small>(per 100,000 inhabitants)</small>
|-
| 1 || ''[[Biology:Salmonella|Salmonella]]'' || ~8,000 cases || align="center"|13
|-
| 2 || ''[[Biology:Campylobacter|Campylobacter]]'' || ~3,000 cases || align="center"|4.8
|-
| 3 || [[Biology:Parasite|Parasite]]s<br />incl. [[Biology:Toxoplasma|Toxoplasma]] || ~500 cases<br />~400 cases || align="center"|0.8<br />0.65
|-
| 4 || ''[[Biology:Listeria|Listeria]]'' || ~300 cases || align="center"|0.5
|-
| 5 || [[Medicine:Hepatitis A|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 || ''[[Biology:Salmonella|Salmonella]]'' || ~300 cases || align="center"|0.5
|-
| 2 || ''[[Biology:Listeria|Listeria]]'' || ~80 cases || align="center"|0.13
|-
| 3 || [[Biology:Parasite|Parasite]]s || ~37 cases || align="center"|0.06<br />(95% due to [[Biology:Toxoplasma|toxoplasma]])
|-
| 4 || ''[[Biology:Campylobacter|Campylobacter]]'' || ~15 cases || align="center"|0.02
|-
| 5 || [[Medicine:Hepatitis A|Hepatitis A]] || ~2 cases || align="center"|0.003
|}
{{Col-end}}

===Australia===

A study by the Australian National University published in 2022 for Food Standards Australia New Zealand estimated there are 4.67&nbsp;million cases of food poisoning in Australia each year that result in 47,900 hospitalisations, 38 deaths and  a cost to the economy of $2.1&nbsp;billion.<ref>{{cite web |title=The Annual Cost of Foodborne Illness in Australia Final Report September 2022 |url=https://www.foodstandards.gov.au/publications/Documents/ANU%20Foodborne%20Disease%20Final%20Report.pdf |website=Food Standards Australia New Zealand |publisher=Australian National University |access-date=8 April 2023}}</ref>

A previous study using different methodology and published in November 2014, found in 2010 that there were an estimated 4.1&nbsp;million cases of foodborne gastroenteritis acquired in Australia on average each year, along with 5,140 cases of non-gastrointestinal illness.<ref>{{cite journal |last1=Kirk |first1=Martyn |title=Foodborne Illness, Australia, Circa 2000 and Circa 2010 |journal=Emerging Infectious Diseases |year=2014 |volume=20 |issue=11 |pages=1857–1864 |publisher=Emerging Infectious Diseases v 20:11 |doi=10.3201/eid2011.131315 |pmid=25340705 |pmc=4214288 }}</ref>



This study replaces a previous estimate of 5.4&nbsp;million cases of foodborne illness in Australia every year, causing:<ref>
{{cite web | url=http://www.ozfoodnet.gov.au/internet/ozfoodnet/publishing.nsf/Content/reports-1/$FILE/foodborne_report.pdf | title=Foodborne illness in Australia. Annual incidence circa 2000 | publisher=OzFoodNet |page=10 |archiveurl=https://webarchive.nla.gov.au/awa/20140125145815/http://ozfoodnet.gov.au/internet/ozfoodnet/publishing.nsf/Content/7BDEF9F8EC3835D9CA257165001AB31D/$File/foodborne_report.pdf |archivedate=2014-01-25 |url-status=dead}}</ref>
* 18,000 hospitalizations
* 120 deaths (0.5 deaths per 100,000 inhabitants)
* 2.1 million lost days off work
* 1.2 million doctor consultations
* 300,000 prescriptions for antibiotics.

Most foodborne disease outbreaks in Australia have been linked to raw or minimally cooked eggs or poultry.<ref>{{cite journal| vauthors = Astridge K, McPherson M, Knope K, Gregory J, Kardamanidis K, Bell E, Kirk M |title=Foodborne disease outbreaks in Australia 2001-2009|journal=Food Australia|date=2011|volume=63 |issue=12|pages=44–50|display-authors=6}}</ref> The Australian Food Safety Information Council estimates that one third of cases of food poisoning occur in the home.<ref>{{cite web|title=Food Hygiene|url=https://www.bupa.com.au/health-and-wellness/health-information/healthy-living/nutrition/eating/doc/food-hygiene|website=BUPA|access-date=13 September 2015|url-status=dead|archive-url=https://web.archive.org/web/20151211131645/https://www.bupa.com.au/health-and-wellness/health-information/healthy-living/nutrition/eating/doc/food-hygiene|archive-date=December 11, 2015|df=mdy-all}}</ref>

===Outbreaks===



==Society and culture==

===United Kingdom===

In postwar Aberdeen (1964) a large-scale (>400 cases) outbreak of typhoid occurred, caused by contaminated corned beef which had been imported from Argentina.<ref>
Smith, David F.; Diack, H. Lesley and Pennington, T. Hugh (2005) ''Food Poisoning, Policy and Politics : Corned Beef and Typhoid in Britain in the 1960s''. Boydell Press. {{ISBN|1-84383-138-4}} 
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<ref>{{cite web|url=http://briandeer.com/social/stanley-royd.htm|title=Food poison deaths probe may reveal NHS flaws|date=February 24, 1985|author=Brian Deer|work=The Sunday Times}}</ref> and the [[Medicine:Bovine spongiform encephalopathy|bovine spongiform encephalopathy]] (BSE, mad cow disease) outbreak identified in the 1980s. The death of 21 people in the 1996 Wishaw outbreak of ''E.&nbsp;coli'' O157<ref>{{cite web|url=http://news.bbc.co.uk/1/hi/health/154107.stm|title=BBC News - Health - Sheriff criticises E. coli butcher}}</ref><ref>{{cite journal | vauthors = Cowden JM, Ahmed S, Donaghy M, Riley A | title = Epidemiological investigation of the central Scotland outbreak of Escherichia coli O157 infection, November to December 1996 | journal = Epidemiology and Infection | volume = 126 | issue = 3 | pages = 335–341 | date = June 2001 | pmid = 11467789 | pmc = 2869700 | doi = 10.1017/S0950268801005520 }}</ref> was a precursor to the establishment of the Food Standards Agency which, according to Tony Blair in the 1998 [[White paper|white paper]] ''A Force for Change'' Cm 3830, "would be powerful, open and dedicated to the interests of consumers".<ref>{{cite web|url=http://www.archive.official-documents.co.uk/document/maffdh/fsa/fsa.htm |title=The Food Standards Agency: A Force for Change |website=gov.uk |publisher=Food Standards Agency, United Kingdom |date=January 14, 1998 |access-date=14 August 2016}}</ref>

In May 2015, for the second year running, England's Food Standards Agency devoted its annual Food Safety Week to "The Chicken Challenge". The focus was on the handling of raw chicken in the home and in catering facilities in a drive to reduce the high levels of food poisoning from the ''campylobacter'' bacterium. Anne Hardy argues that widespread public education of food hygiene can be useful, particularly through media (TV cookery programmes) and advertisement. She points to the examples set by [[Place:Scandinavia|Scandinavia]]n societies.<ref>{{Cite web|url=http://www.historyandpolicy.org/policy-papers/papers/food-poisoning-an-on-going-saga|title=Food Poisoning: An On-going Saga |last=Hardy |first=Anne | name-list-style = vanc |date=13 January 2016|website=History and Policy|access-date=4 July 2016}}</ref>

===United States===
In 2001, the [[Organization:Center for Science in the Public Interest|Center for Science in the Public Interest]] petitioned the [[Organization:United States Department of Agriculture|United States Department of Agriculture]] to require meat packers to remove [[Biology:Spinal cord|spinal cord]]s before processing cattle carcasses for human consumption, a measure designed to lessen the risk of infection by variant [[Medicine:Creutzfeldt–Jakob disease|Creutzfeldt–Jakob disease]]. The petition was supported by the [[Organization:American Public Health Association|American Public Health Association]], the Consumer Federation of America, the Government Accountability Project, the National Consumers League, and Safe Tables Our Priority.<ref>{{cite web|url=https://www.federalregister.gov/articles/2004/01/12/04-626/meat-produced-by-advanced-meatbone-separation-machinery-and-meat-recovery-amr-systems#footnote-10 |access-date=3 July 2016 |title=Meat Produced by Advanced Meat/Bone Separation Machinery and Meat Recovery (AMR) Systems |website=Federal Register |publisher=U.S. National Archive and Records Administration|date=2004-01-12 }}</ref>

None of the US Department of Health and Human Services targets<ref>{{cite web|url=http://www.healthypeople.gov|title=Healthy People 2010 Home Page}}</ref> regarding incidence of foodborne infections were reached in 2007.<ref>{{cite journal | title = Preliminary FoodNet data on the incidence of infection with pathogens transmitted commonly through food--10 states, 2007 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 57 | issue = 14 | pages = 366–370 | date = April 2008 | pmid = 18401330 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5714a2.htm | author1 = Centers for Disease Control Prevention (CDC) }}</ref>

A report issued in June 2018 by NBC's Minneapolis station using research by both the CDC and the Minnesota Department of Health concluded that foodborne illness is on the rise in the U.S.<ref>{{cite web|url=https://www.kare11.com/article/news/why-are-we-seeing-so-many-food-recalls/89-564858966|title=Why are we seeing so many food recalls?|publisher=KARE 11|first1=Gordon|last1=Severson | name-list-style = vanc |date=June 15, 2018|access-date=June 19, 2018}}</ref>

=== India ===
In India, ''[[Biology:Entamoeba|Entamoeba]]'' is the most common cause of food illness, followed by ''[[Biology:Campylobacter|Campylobacter]]'' bacteria, ''[[Biology:Salmonella|Salmonella]]'' bacteria, [[Biology:Escherichia coli|''E.&nbsp;coli'']] bacteria, and [[Medicine:Norovirus|norovirus]].<ref name=":1">{{Cite news |title=Symptoms of food poisoning |work=The Times of India |url=https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/how-fast-does-food-poisoning-set-in-what-are-the-symptoms-one-should-know/photostory/79493562.cms?picid=79493721 |access-date=2023-05-29 |issn=0971-8257}}</ref> According to statistics, food poisoning was the second most common cause of infectious disease outbreak in India in 2017. The numbers of outbreaks have increased from 50 in 2008 to 242 in 2017. <ref name=":1" />

===Organizations===


===International Food Safety Authorities Network (INFOSAN)===


# Promoting the rapid exchange of information during food safety events;
# Sharing information on important food safety issues of global interest;
# Promoting partnership and collaboration between countries; and
# Helping countries strengthen their capacity to manage food safety risks.


===Prioritisation of foodborne pathogens===

The Food and Agriculture Organization of the United Nations and The World Health Organization have published a global ranking of foodborne parasites using a multicriteria ranking tool concluding that ''Taenia solium'' was the most relevant, followed by ''Echinococcus granulosus'', ''Echinococcus multilocularis'', and ''Toxoplasma gondii''.<ref name=fao>{{cite book |publisher=FAO/WHO |title=Multicriteria-based ranking for risk management of foodborne parasites |series=Microbiological Risk Assessment Series No. 23 |date=2014 |isbn=978-92-5-108199-0 |url=http://www.fao.org/publications/card/en/c/ee07c6ae-b86c-4d5f-915c-94c93ded7d9e/}}</ref> The same method was used regionally to rank the most important foodborne parasites in Europe ranking ''Echinococcus multilocularis'' of highest relevance, followed by ''Toxoplasma gondii'' and ''Trichinella spiralis''.<ref name=eur>{{cite journal | vauthors = Bouwknegt M, Devleesschauwer B, Graham H, Robertson LJ, van der Giessen JW | title = Prioritisation of food-borne parasites in Europe, 2016 | journal = Euro Surveillance | volume = 23 | issue = 9 | date = March 2018 | pmid = 29510783 | pmc = 5840924 | doi = 10.2807/1560-7917.ES.2018.23.9.17-00161 }}</ref>

===Regulatory steps===

* European Commission Regulation (EC) No 2073/2005 of November 15, 2005
* European Committee for Standardization (CEN): Standard method for the detection of norovirus and hepatitis A virus in food products (shellfish, fruits and vegetables, surfaces and bottled water)
* CODEX Committee on Food Hygiene (CCFH): Guideline for the application of general principles of food hygiene for the control of viruses in food<ref>[http://ec.europa.eu/food/safety/international_affairs/standard_setting_bodies/codex/organisations/eupositions/ccfh/index_en.htm "Codex Committee on Food Hygiene (CCFH)"], European Commission, Retrieved April 7, 2015</ref>

== See also ==
{{div col|colwidth=22em}}
* ''American Public Health Association v. Butz''
* [[Medicine:Food allergy|Food allergy]]
* [[Biology:Food microbiology|Food microbiology]]
* [[Engineering:Food quality|Food quality]]
* Food safety
* Food spoilage
* Food testing strips
* [[Medicine:Gastroenteritis|Gastroenteritis]]
* List of foodborne illness outbreaks by country
* List of food contamination incidents
* Mycotoxicology
* STOP Foodborne Illness
* United States Disease Control and Prevention
* [[Biology:Zoonosis|Zoonotic pathogens]]
{{div col end}}

== References ==
{{CDC}}
{{Reflist|30em}}

== Further reading ==

=== Periodicals ===
* [http://www.sciencedirect.com/science/journal/01681605 International Journal of Food Microbiology], {{ISSN|0168-1605}}, Elsevier
* [http://www.liebertpub.com/FPD Foodborne Pathogens and Disease], {{ISSN|1535-3141}}, Mary Ann Liebert, Inc.
* ''Mycopathologia'', {{ISSN|1573-0832}} (electronic), {{ISSN|0301-486X}} (paper), Springer

=== Books ===
* {{cite book |first1=Ailsa D. |last1=Hocking |first2=John I. |last2=Pitt |first3=Robert A. |last3=Samson |first4=Ulf |last4=Thrane | name-list-style = vanc |title=Advances in Food Mycology |url=https://books.google.com/books?id=9xlIicZfQ5IC |date= 2005 |publisher=Springer |isbn=978-0-387-28385-2}} {{ISBN|978-0-387-28391-3}} (electronic).
* {{cite book |first=Betty C. |last=Hobbs | name-list-style = vanc |title=Food Poisoning and Food Hygiene |journal=British Medical Bulletin |volume=7 |issue=3 |pages=167–70 |publisher=Edward Arnold |year=1993 |isbn=978-0-340-53740-4|pmid=14821218 |doi=10.1093/oxfordjournals.bmb.a073825 }}
* {{cite book |first1=Hans P. |last1=Riemann |first2=Dean O. |last2=Cliver | name-list-style = vanc |title=FoodBorne Infections and Intoxications |url=https://books.google.com/books?id=_OsZ9TcQTSsC&pg=PA485 |year=2006 |publisher=Academic Press |isbn=978-0-12-588365-8}}
* {{cite book |first=James L. |last=Smith | name-list-style = vanc |title=Foodborne Pathogens: Microbiology And Molecular Biology |url=https://books.google.com/books?id=-HNavPPs-JoC |year=2005 |publisher=Horizon Scientific Press |isbn=978-1-904455-00-4 |editor1-first=Pina M. |editor1-last=Fratamico |editor2-first=Arun K. |editor2-last=Bhunia |editor3-first=James L. |editor3-last=Smith}}

== External links ==
<!--==========================({{NoMoreLinks}})============================
    | PLEASE BE CAUTIOUS IN ADDING MORE LINKS TO THIS ARTICLE. WIKIPEDIA  |
    | IS NOT A COLLECTION OF LINKS NOR SHOULD IT BE USED FOR ADVERTISING. |
    |                                                                     |
    |           Excessive or inappropriate links WILL BE DELETED.         |
    | See Wikipedia:External links & Wikipedia:Spam for details.  |
    |                                                                     |
    | If there are already plentiful links, please propose additions or   |
    | replacements on this article's discussion page, or submit your link |
    | to the relevant category at the Open Directory Project (dmoz.org)   |
    | and link back to that category using the {{dmoz}} template.         |
    =========================({{NoMoreLinks}})=============================-->
* [https://web.archive.org/web/20040227015929/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] {{Webarchive|url=https://web.archive.org/web/20191230124336/http://www.foodauthority.nsw.gov.au/fb-foodborne-illness.htm |date=December 30, 2019 }}, NSW Food Authority
* [https://web.archive.org/web/20040227020759/http://www.who.int/mediacentre/factsheets/fs237/en/ Food safety and foodborne illness], WHO, Fact sheet N°237, revised January 2002
* [https://web.archive.org/web/20140221152928/http://www.hpa.org.uk/infections/ UK Health protection Agency]
* [https://www.cdc.gov/pulsenet/ US PulseNet]
* [https://www.nhs.uk/conditions/food-poisoning/ Food poisoning] from NHS Direct Online
* [https://web.archive.org/web/20081017180615/http://www.foodsafetynetwork.ca/en/ Food Safety Network] hosted at the University of Guelph, Canada.
* [https://www.food.gov.uk/ Food Standard Agency website]

{{Concepts in infectious disease}}
{{Consumer Food Safety}}

{{DEFAULTSORT:Foodborne Illness}}
[[Category:Food safety]]

{{Sourceattribution|Foodborne illness}}