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Page Title:
Table 1-10. Guidelines for confirmation of foodborne-disease outbreaks (Cont) |
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|  MANUAL OF NAVAL PREVENTIVE MEDICINE
Etiologic agent
Incubation
Clinical syndrome
Confirmation
period
Isolation of >106 organisms/g
6-24 hrs
Diarrhea, abdominal
5. Clostridium
crampsl vomiting and
in stool of two or more ill
perfringens
fever are uncommon
persons, provided specimen
properly handled
OR
Demonstration of enterotoxin
in the stool of two or more
ill persons
OR
Isolation of >105 organisms/g
from epidemiologically
implicated food, provided
specimen properly handled
6. Escherichia coli
1-10 days,
Diarrhea (often
Isolation of E. coli 0157:H7
a. Entero-
usually 3-
bloody), abdominal
or other Shiga-like toxin-
hemorrhagic (E.
4 days
cramps (often severe),
producing E. coli from
coli 0157:H7
little or no fever
clinical specimen of two or
and others)
more ill persons
OR
Isolation of E. coli 0157 or
other Shiga-like toxin-
producing E. coli from
epidemiologically implicated
food
b. Enterotoxigenic
6-48 hrs
Diarrhea, abdominal
Isolation of organism of same
(ETEC)
cramps, nausea;
serotype, which are
vomiting and fever are
demonstrated to produce heat-
less common
stable (ST) and/or heat-
labile (LT) enterotoxin, from
stool or two or more ill
persons
c. Enteropatho-
Variable
Diarrhea, fever,
Isolation of same
genic (EPEC)
abdominal cramps
enteropathogenic serotype
from stool of two or more ill
persons
d. Enteroinvasive
Variable
Diarrhea (may be
Isolation of same
(EIEC)
bloody), fever,
enteroinvasive serotype from
abdominal cramps
stool of two or more ill
persons
7. Listeria
monocytogenes
a. Invasive
2-6 wks
Meningitis, neonatal
Isolation of organism from
disease
sepsis, fever
normally sterile site
b. Diarrheal
Unknown
Diarrhea, abdominal
Isolation of organism of same
disease
cramps, fever
serotype from stool of two or
more ill persons exposed to
food that is epidemio-
logically implicated or from
which organism of same
serotype has been isolated
136
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