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Page Title: Table 1-10. Guidelines for confirmation of foodborne-disease outbreaks (Cont)
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CHAPTER 1, FOOD SAFETY
Etiologic agent
Incubation
Clinical syndrome
Confirmation
period
Demonstration of histamine in
Flushing, dizziness
b. Scombroid toxin
1 min-3
epidemiologically implicated
burning of mouth and
(histamine)
hrs,
food
throat, headache,
usually <1
OR
gastrointestinal
hr
Clinical syndrome among
symptoms, urticaria,
persons who have eaten type
and generalized
of fish previously associated
pruritus
with histamine fish poisoning
(e.g., mahi-mahi or fish of
order Scomboidei)
Detection of toxin in
30 min-3
Parasthesia or lips,
c. paralytic or
epidemiologically implicated
hrs
mouth or face, and
neurotoxic
food
extremities;
shellfish
OR
intestinal symptoms or
poison
Detection of large numbers of
weakness, including
shellfish-poisoning-
respiratory difficulty
associated species of
dinoflagellates in water from
which epidemiologically
implicated mollusks are
gathered
d. Puffer fish,
10 min-3
Parasthesia of lips,
Demonstration of tetrodotoxin
tetrodotoxin
hrs,
tongue, face, or
in epidemiologically
usually
extremities, often
implicated fish
10-45 mins
following numbness;
OR
loss of proprioception
Clinical syndrome among
or "floating"
persons who have eaten puffer
sensations
fish
2. Heavy metals
5 min-8
Vomiting, often
Demonstration of high
a. Antimony
hrs,
metallic taste
concentration of metal in
b. Cadmium
usually <1
epidemiologically implicated
c. Copper
hr
food
d. Iron
e. Tin
f. Zinc
3. Monosodium
3 mins-2
Burning sensation in
Clinical syndrome among
glutamate (MSG)
hrs,
chest, neck, abdomen,
persons who have eaten food
usually <1
or extremities;
containing MSG (i.e., usually
hr
sensation of lightness
>1.5 g MSG)
and pressure over face
or heavy feeling in
chest
139


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