William T. Anderson Epidemiology:,Foodborne, Disease
Chronic, Seguelae Prevention and Surveillance
Prevention Chapter, References
Foodborne and waterborne disease is the most widespread public health challenge facing contemporary medicine. The spectrum of illness is changing with the emergence of new pathogens and reemergence of old ones. Individual outbreaks of foodborne or waterborne illnesses have caused sickness in hundreds of thousands of people. The number of identified outbreaks has increased over the past 20 years.1 The globalization of the food economy and explosion in international travel have facilitated the transmission of disease between continents.1 Patients can present with uncommon pathogens and develop life-threatening complications or chronic illnesses. Emergency physicians need to understand the scope and magnitude of foodborne and waterborne illnesses. They should be able to recognize risk factors in the vast population of patients who present with diarrheal illness that compels a more aggressive investigation. Physicians should be cognizant of which pathogens can and cannot be tested for in their laboratory. Finally, emergency physicians should instruct patients on how to reduce their risk in the future. Specific etiologic agents and the general management of infectious diarrhea are covered elsewhere in this text.
Foodborne and waterborne illnesses encompass a variety of clinical and etiologic conditions. Waterborne illness is defined by the Centers for Disease Control and Prevention (CDC) as an illness that occurs after consumption or use of water intended for drinking or as illness associated with recreational water such as swimming pools, whirlpools, hot tubs, spas, water parks, and naturally occurring fresh and marine surface waters.2 A foodborne-illness outbreak is the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food.3 Food or water may act as a vehicle for transmission of actively growing organisms or as a transfer medium for nonreplicating viruses, toxins, protozoa, bacteria, or chemical agents.
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