microbiology

• dental caries
• periodontal disease

peptic ulcer disease

• salmonellasis
• shigellosis
• cholera
• e coli
• clostridium difficile
• campylobacteriosis

• botulism
• staphylococcal food poisoning
• clostridial food poisoning

• mumps
• gastroenteritis
• hepatitis

• giardiasis
• cryptosporidiosis
• amoebiasis

• pinworm
• trichinosis
• hookworms

• cause tooth decay
• cause: strep. mutans ad strep. sobrinus; use sucrose to produce Fructans and glucans to stick to teeth and colonize (tooth and gum area)
• produce acid as they ferment sugar to acids erode enamel
• prevention - oral hygeine, food combinations

gingivitis - inflammation of gums lead to bleeding and receding gum lines, eventually tooth loss

• ph 1&2
• cause: helicobacteria pylori- spirochete (use flagellum and spiral).  secretes protein to decrease acid production and produce urease which breaks down urea which leads to a rise in ph.  inflammation triggers ulcers  wbc come into fight
• transmission - oral/oral or oral/fecal, zoonosis
• treatment - antacids (proton pump) and antibiotics

• cause: salmonella enterica
• associated with poultry and reptiles
• transmission:  contaminated (fecal) poultry and products, eggs, handling reptiles, ingest million + cells
• onset 6-48hrs - nausea, vomiting, cramping, diarrhea, myalgia
• treatment - hydration
• prevention - poultry vaccine

• cause: shigella species
• s. sonnei - industrialized nations
• s. dysentarae - developed countries, more serious illness 20% mortality
• s. flexneri - dev. countries

FCFW, close personal contact, poor sanitation

• frequent watery stools, N/V
• can develop to dysentery (ulcers in stomach and intestines)

shiga toxin- stops protein synthesis in epithelial cells and kills them, lining dying , ulcerations froming

hydration, self-limiting, dysentery; ciprofloxacin

live attentuated

• vibrio cholerae
• gram negative
• curved bacillus
• cholera toxin - typical A-B toxin, B-attaches to host to trigger endocytossis the A part of toxin causes damage inside cell.  pump electrolytes out of host cell, water follows, water of intestinal

FCFW

few hours to days

rapid onset secretory diarrhea - rice water stools, colorless, odorless, severe dehydration - up to 20 liters perday

rehydration (w/electrolytes)

limited use, short lived

• GI tract of animals
• indicator MO - detect fecal contamination
• O antigens - LPS polysaccharide
• H antigens - flagellar antigens

• enterotoxigenic E coli
• travelers diarrhea
• watery diarrhea
• cholera like toxin

• enteroinvasive E coli
• similar to shigella
• stools have blood and pus
• 3rd world countries

• enteroaggregative E coli
• chronic diarrhea in young children and AIDS patients

• enteropathogenic Ecoli
• fever
• vomiting
• watery diarrhea
• lacks shiga toxin (won't cause ulceration)

• enterohemorrhagic Ecoli
• 10% HUS (Hemolytic Uremic Syndrome)
• bloody diarrhea
• abdominal cramping
• Ecoli 0157:H7

cause: often E coli

• c. diff
• gram +
• endosproe
• anaerobic bacillus
• antibiotic therapy causes or contributes to infection; you throw off normal flora
• pseudomembranous colitis - diarrhea, necrosis of intestinal wall (enterotoxins)
• use soap and water, not sanitizer

• campylobacter jejuni
• gram -
• curved bacillus
• domestic animals reservoir includes cows, goats, chickens, dogs, cats, rabbits

FCFW or unpasteurized milk

• diarrhea frequent
• can be bloody
• up to 10's daily
• fever
• cramps
• self limiting within 7-10 days

proper food sanitation

• cause: staph aureus, gram + cocci, enterotoxin (heat stable, boiling over 30 minutes to kill toxin)
• symptoms: 1-3 hours; nausea, vomiting, diarrhea
• source:  buffets

• cause: clostrium perfringens, gram + endospore anaerobic bacillus, enterotoxin
• symptoms: diarrhea, cramp, nausea & vomiting
• source: contaminated protein rich foods (meat, poultry, and beans)
• treatment: keep hydrated, self-limiting, no anti-diarrheals

• cause: mumps virus - paramyxoviridae
• transmission: salivary and resp. secretions
• incubation: 2-3 weeks
• symptoms: cold and parotitis (swollen lymph), parotitis - inflammation of parotid salivary glands; orchitis- inflammation of testes
• vaccine: MMR - live attenuated

• rotavirus - diarrhea that can last a week
• vaccine - rotateq and rotarix; 2&4 months
• norovirus - vomiting and diarrhea

inflammation of liver

• picornaviridae
• transmitted: oral/fecal route, FCFW
• incubation: 3-5 weeks
• symptoms: mild- jaundice, N&V, anorexia

• hepadnaviridae
• transmission: blood and blood products, STD, can cross placenta
• symptoms: jaundice, bruising due to liver issues
• vaccine: hep B vaccine; series of 3 followed by titer

• Flaviviridae
• transmission: blood and blood products, STD, can cross placenta, dirty needles
• at risk: IV drug abusers and prostitutes
• symptoms: mild
• 65% asymptomatic
• 25% jaundice

• giardia lamblia & giardia intestinalis
• flagellate, diplomonadida

fecal contaminated water (muskrat or beaver, raccoons and dogs); ingest cyst

6-20 days - depends on how much you take in

• cramping
• diarrhea
• flatulence
• n&v

• flagyl or atrabine
• vaccine for dogs

• cause: cryptosporidium parvum, farm animals including cows
• transmission: FCFW, ingest cyst
• incubation: 6 days
• symptoms:  watery diarrhea for 10-14 days, fever, anorexia,and nausea; risk for immunocompromised
• treatment: rehydration

• cause: entamoeba histolytica
• transmission: FCFW, ingest cyst
• incubation: 2day to a month
• symptom: diarrhea and cramping, can progress to dysentery
• treatment: flagyl or other

• roundworm
• cause: enterobius vermicularis
• transmission: fecal - oral route
• symptoms: perianal itching, due to female laying eggs around anus at night
• treatment: self limiting but can prescribe antihelminthic

• roundworm
• cause: trichinella spiralis
• transmission: ingest undercooked infected meat (pork also game like bears)
• symptoms: fever and muscle pain (these worms inbed in muscle)
• treatment: anti H (helminthic) drug

• cause: ancylostoma duodenale (old); necator americanus (new world)
• transmission: shed in feces, larva attach to vegetation; larvae penetrate skin (feet), enter blood travel to lungs, mature and lay eggs, swallow and infect GI tract, can cause anemia