Foodborne illnesses are usually infectious or toxic in nature and caused by bacteria, viruses, parasites or chemical substances entering the body through contaminated food or water.
Foodborne pathogens can cause severe diarrhoea or debilitating infections including meningitis.
Chemical contamination can lead to acute poisoning or long-term diseases, such as cancer. Foodborne diseases may lead to long-lasting disability and death. Examples of unsafe food include uncooked foods of animal origin, fruits and vegetables contaminated with faeces, and raw shellfish containing marine biotoxins.
Bacteria:
- Salmonella, Campylobacter, and Enterohaemorrhagic Escherichia coli are among the most common foodborne pathogens that affect millions of people annually – sometimes with severe and fatal outcomes. Symptoms are fever, headache, nausea, vomiting, abdominal pain and diarrhoea. Examples of foods involved in outbreaks of salmonellosis are eggs, poultry and other products of animal origin. Foodborne cases with Campylobacter are mainly caused by raw milk, raw or undercooked poultry and drinking water. Enterohaemorrhagic Escherichia coli is associated with unpasteurized milk, undercooked meat and fresh fruits and vegetables.
- Listeria infection leads to unplanned abortions in pregnant women or the death of newborn babies. Although disease occurrence is relatively low, listeria’s severe and sometimes fatal health consequences, particularly among infants, children and the elderly, count them among the most serious foodborne infections. Listeria is found in unpasteurised dairy products and various ready-to-eat foods and can grow at refrigeration temperatures.
- Vibrio cholerae infects people through contaminated water or food. Symptoms include abdominal pain, vomiting and profuse watery diarrhoea, which may lead to severe dehydration and possibly death. Rice, vegetables, millet gruel and various types of seafood have been implicated in cholera outbreaks.
Antimicrobials, such as antibiotics, are essential to treat infections caused by bacteria. However, their overuse and misuse in veterinary and human medicine has been linked to the emergence and spread of resistant bacteria, rendering the treatment of infectious diseases ineffective in animals and humans. Resistant bacteria enter the food chain through the animals (e.g. Salmonella through chickens). Antimicrobial resistance is one of the main threats to modern medicine.
Viruses:
Norovirus infections are characterized by nausea, explosive vomiting, watery diarrhoea and abdominal pain. Hepatitis A virus can cause long-lasting liver disease and spreads typically through raw or undercooked seafood or contaminated raw produce. Infected food handlers are often the source of food contamination.
Parasites:
Some parasites, such as fish-borne trematodes, are only transmitted through food. Others, for example, tapeworms like Echinococcus spp, or Taenia solium, may infect people through food or direct contact with animals. Other parasites, such as Ascaris, Cryptosporidium, Entamoeba histolytica or Giardia, enter the food chain via water or soil and can contaminate fresh produce.
Prions:
Prions, infectious agents composed of protein, are unique in that they are associated with specific forms of neurodegenerative disease. Bovine spongiform encephalopathy (BSE, or “mad cow disease”) is a prion disease in cattle, associated with the variant Creutzfeldt-Jakob Disease (vCJD) in humans. Consuming bovine products containing specified risk material, e.g. brain tissue, is the most likely route of transmission of the prion agent to humans.
Chemicals:
Of most concern for health are naturally occurring toxins and environmental pollutants.
- Naturally occurring toxins include mycotoxins, marine biotoxins, cyanogenic glycosides and toxins occurring in poisonous mushrooms. Staple foods like corn or cereals can contain high levels of mycotoxins, such as aflatoxin and ochratoxin, produced by mould on grain. A long-term exposure can affect the immune system and normal development, or cause cancer.
- Persistent organic pollutants (POPs) are compounds that accumulate in the environment and the human body. Known examples are dioxins and polychlorinated biphenyls (PCBs), which are unwanted by-products of industrial processes and waste incineration. They are found worldwide in the environment and accumulate in animal food chains. Dioxins are highly toxic and can cause reproductive and developmental problems, damage the immune system, interfere with hormones and cause cancer.
- Heavy metals such as lead, cadmium and mercury cause neurological and kidney damage. Contamination by heavy metal in food occurs mainly through pollution of air, water and soil.
The burden of foodborne diseases
The burden of foodborne diseases to public health and welfare and the economy has often been underestimated due to underreporting and difficulty to establish causal relationships between food contamination and resulting illness or death.
The 2015 WHO report on the estimates of the global burden of foodborne diseases presented the first-ever estimates of disease burden caused by 31 foodborne agents (bacteria, viruses, parasites, toxins and chemicals) at the global and regional level.
