Fundamental Food Microbiology, Third Edition - Fuad Fathir

376 FUNDAMENTAL FOOD MICROBIOLOGY
and pus, fever, chills, and headache. Generally, children are more susceptible to the
disease than adults. 22–25
F. Food Association
Shigella cells are present in a food only through fecal contamination, directly or
indirectly, from a person either suffering from the disease, or a carrier or a person
who has not developed symptoms yet but is shedding the pathogens in feces. Direct
contamination occurs from poor personal hygiene. Indirect contamination occurs
from the use of fecal-contaminated water to wash foods that are not subsequently
heat processed. Also, cross-contamination of ready-to-eat foods can be involved in
an outbreak. Foods often implicated in shigellosis are those that are handled too
much and are ready-to-eat.
In many developed countries, the most frequently involved foods are different
types of salads (potato, tuna, shrimp, and chicken), with potato salads ranked at the
top. Foods that are chopped, diced, or cut prior to eating, such as vegetables used
in salads, have also been involved in outbreaks. Shellfish harvested from sewagepolluted
water and eaten raw have been associated with shigellosis. Many foods
support their growth. As the infective dose is very low, growth in food is probably
not an important factor for the disease. 22–25
G. Prevention
Foodborne shigellosis, at least in the developed countries, is caused by contamination
of foods by food handlers shedding the pathogen in the feces and having poor
personal hygiene. To prevent contamination of ready-to-eat food by such individuals,
it is necessary to forbid them to handle such foods. Quite often, this is impossible,
especially if the individual is a carrier. Proper education of the food handlers about
the importance of good personal hygiene and the need to not handle food if one
suspects having a digestive disorder is important. Use of rigid sanitary standards to
prevent cross-contamination of ready-to-eat food, use of properly chlorinated water
to wash vegetables to be used for salads, and refrigeration of foods are necessary
to reduce foodborne shigellosis. 22–25
VI. CAMPYLOBACTERIOSIS BY CAMPYLOBACTER SPP.
(CAMPYLOBACTER ENTERITIS AND CAMPYLOBACTER
JEJUNI ENTERITIS)
A. Importance
Several Campylobacter species can cause human gastroenteritis; however, Campylobacter
jejuni and Cam. coli are considered the most common causative agents of
human diarrheal disease in many countries worldwide. In many countries, the number
of cases of campylobacteriosis probably far exceeds the combined number of
salmonellosis and shigellosis cases. Epidemiological data have confirmed this in