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CHAPTER 1, FOOD SAFETY
Table 1-10. Guidelines for confirmation of foodborne-disease
outbreaks
Etiologic agent
Incubation
Clinical syndrome
Confirmation
period
Bacterial
1. Bacillus cerus
Isolation of organism from
a. Vomiting toxin
1-6 hrs
Vomiting, some
stool of two or more ill
patients with
persons and not from stool of
diarrhea; fever
controls
uncommon
OR
Isolation of >105 organisms/g
from epidemiologically
implicated food, provided
specimen properly handled
b. Diarrheal toxin
6-24 hrs
Diarrhea, abdominal
Isolation of organism from
cramps, and vomiting
stool of two or more ill
in some patients,;
persons and not from stool of
fever uncommon
controls
OR
Isolation of >105 organisms/g
from epidemiologically
implicated food, provided
specimen properly handled
Several
Weakness, fever,
Two or more ill persons and
2. Brucella
days to
headache, sweats,
isolation of organism in
several
chills, arthralgia,
culture of blood or bone
mos,
weight loss,
barrow, greater than fourfold
usually
splenomegaly
increase in standard
>30 days
agglutination titer (SAT)
over several wks, or single
SAT titer >1:160 in person
who has compatible clinical
symptoms and history of
exposure
2-10 days,
Diarrhea (often
Isolation of organism from
3. Campylobacter
usually 2-
bloody), abdominal
clinical specimens from two
5 days
pain, fever
or more ill persons
OR
Isolation of organism from
epidemiologically implicated
food
2 hrs-8
Illness of variable
Detection of botulinal toxin
4. Clostridium
days,
severity; common
in serum, stool, gastric
botulinum
usually
symptoms are diplopia,
contents, or implicated food
12-48 hrs
blurred vision, and
OR
bulbar weakness;
Isolation of organism from
paralysis, which is
stool or intestine
usually descending and
bilateral, may
progress rapidly
135


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