Food poisoning caused by Clostridium spp

Food poisoning caused by Clostridium spp:

There are two species of Clostridium which causes the severe type of food poisoning i.e Clostridium botulinum and Clostridium perfringens. These organisms cause food poisoning through mechanisms of foodborne infection and food-borne intoxication. Clostridium botulinum causes food intoxication and releases Botulinum toxin and Clostridium perfringens causes food infection. Clostridium spp is Gram positive bacteria which are anaerobic and spore formers. These organisms are rod-shaped bacteria and non-motile. Generally canning, cooking kills vegetative cells but does not necessarily spores. Under the appropriate condition, spores may generate and cause foodborne illness.

Food poisoning caused by Clostridium botulinum :

Botulism :

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Botulism is a severe food poisoning which is one of the fatal types of poisoning and occurs by following consumption of food containing exotoxin (neurotoxin) produced by anaerobic Gram-positive Clostridium botulinum. Hence it is called as foodborne intoxication. There are two types of Botulism:

1. Infant botulism
2. Wound botulism

• Infant botulism:

Infant botulism is related to found in infants. Its toxin is found in fruit items like honey and the problem generally, begins within 18-36 hours after the toxin enters the baby's body.

Signs and Symptoms :

Its signs and symptoms include :

1. Constipation (often the first sign) occurs.
2. Floppy movements due to muscle weakness and trouble controlling the head.
3. Weak cry, irritability, drooling, paralysis, drooping eyelids, etc occurs in infants.
4. Tiredness and difficulty in sucking milk or feeding occurs.

• Wound botulism:

Most people who develop wound botulism inject drugs several times a day. So it is difficult to determine how long it takes for signs and symptoms to develop after the toxin enters the body. Most commonly occur in people who inject black tar, heroine, etc.

Signs and Symptoms:

Its signs and symptoms include:

1. Difficulty in swallowing or speaking.
2. Facial weakness on both sides of the face.
3. Blurred or double vision.
4. Drooping eyelids, trouble in breathing may occur.
5. Paralysis.

Organisms:

Botulinum is caused by the certain strain of Clostridium botulinum, which is Gram-positive anaerobic spore-forming the rod with oval to cylindrical in shape and has the terminal to subterminal spores. The bacterium may be saprophytic and are normally found in soil and may contaminate raw food before harvest and slaughter. It produces seven different types of Botulinum toxin i.e. A, B, C, D, E ,F and G. TypeA, B,E ,F, and G causes disease in human. Type C causes disease in fowls (poultry), cattle and other animals and Type D is associated with poisoning in cattle.

Food involved:

Generally, inadequately processed home canned food are most often the causes of Botulism. Among the home canned, those most often responsible for botulism are canned sweet corn, asparagus, spinach, preserved fish and meat, smoked meat, etc that are eaten raw without cooking. Spore of Clostridium botulinum germinate during heat treatment and resulting cells may produce toxin.

Pathogenesis and disease:

Botulism is a potentially lethal condition caused by Botulinum neurotoxin. Its pathogenesis can be described as :

1. The neurotoxin entered the body via gastrointestinal tract or through the mucous membrane.
2. After entering into a body, the neurotoxin is absorbed by blood and lymphatic circulation, which then mediate the toxin to nerve ending of motor neuron.
3. After it, motor neuron blocks the neurotransmitter release such as acetylcholine because transmission of nerve impulses to the muscle is through acetylcholine interacts through muscle reaction.
4. In botulism poisoning, the muscle cannot receive excitatory signals and contraction is prevented and finally causes a flaccid paralysis.

The typical symptoms of Botulism usually appear within 12-16 hours although a longer time may require. The earliest symptoms include digestive disturbance followed by nausea, vomiting, diarrhea, fatigue, etc. such symptoms followed by

1. passive paralysis may occur.
2. double vision slurred speech
3. dry mouth and difficulty in swallowing and in speaking.
4. As the disease progressed, paralysis of the limb and respiratory dysfunction occurs.
5. In fatal cases, death usually occurs within 3-6 days after the poisonous food have been ingested.

Lab diagnosis:

Diagnosis is done by detection of toxin or defensive proteins formed in patient serum or detection of organisms in suspected food. Laboratory finding is coupled with clinical observative ion including neurological dysfunctions (localized paralysis) impaired vision and speech beginning 18-24 hours after ingestion of the contaminated toxin.

Prevention and treatment:

Treatment can be done by following ways:

1. The use of antitoxin which includes artificial respiration (mechanical ventilation) ,
2. By maintaining the fluid balance, physical therapy, etc.

The following are some measures for its prevention:

1. The prevention requires maintaining careful control over canning and preservation method.
2. The preservative measure includes rejection of all gassy (swollen) or spoiled canned food.
3. Avoidance of food that has been cooked improperly.
4. Avoidance of eating raw food items that have been washed and cleaned improperly.

Food poisoning caused by Clostridium perfringens :

Food poisoning caused by Clostridium perfringens is an example of foodborne infection rather than foodborne intoxication as high number viable cells of Clostridium perfringens must be ingested along with food in order to cause food poisoning.

Organism:

The causative agent of Clostridium gastroenteritis is Clostridium perfringens. It is an anaerobic Gram-positive organism which is non-motile spore formers and rod-shaped. These are commonly found in soil. However, it is also found in small number in the intestinal tract of many animals and is therefore found in sewage. The maximum temperature for this organism is about 55*C and optimum being 43-47*C.

Food involved:

The disease results from ingestion of the large dose of Clostridium perfringens (more than 10⁸ cells). In contaminated food, organism survives in high temperature and in high protein containing food of animal origin such as meat and meat products, soups, gravies, milk, etc. To lesser extent poultry product, pork, lamb, fish, legumes, potato, salad, macro ni, cheese, etc may contain Clostridium perfringens.

Pathogenesis and disease:

The pathogenesis of Clostridium perfringens follow the following mechanism during food poisoning:

After consumption of contaminating food, the viable Clostridium perfringens begin to sporulate in the intestine, within the production of certain metabolites that acts as similar to enterotoxin.

Such metabolites alter the permeability of intestinal cramp.

Other common symptoms include fever, chills, headache.

Symptoms are associated with young and elderly people and the onset of perfringens food poisoning begins after 1-2 days after consumption of food and resolves within the short period of time. The fatality rate is very rare and the enterotoxin is relatively heated sensitive and is density at 60*C for 10 minutes.

Lab diagnosis:

Diagnosis can be done with detection of toxins in the stool sample of affected individuals. The illness can be confirmed by detection and isolation of Clostridium perfringens in suspected food and food products that were consumed by patients.

Prevention and treatment:

The prevention of Clostridium perfringens food poisoning can be done by following ways:

The prevention of contamination of raw or cooked food and control of cooking and canning procedures to ensure proper heat treatment.

Preventive measures also include adequate and proper cooling of cooked food.

We should be aware of quality and proper hygiene of proteins containing food like meat and meat products, soups, gravies, milk, legumes, potato, salad, macro ni, cheese, etc.

Treatment:

The treatment of Clostridium perfringens usually is not necessary because it is a self-limiting disease. In severe cases, intravenous fluid and electrolytes may be used for replacement of dehydration condition.

Reference:

1. Alexander, M. Introduction to Soil Microbiology. Academic Press, 1961.
2. Rangaswami, G and Bagyaraja PT. Agricultural Microbiology. 2nd. Prentice Hall of India, 1993.
3. RM, Atlas and R Bartha. Microbial Ecology : Fundamental and Applications. The Benjamin Cummins Publication Co. Inc., 1998.