Staphylococcus Aureus : Do you know what you’re eating?

1. Staphylococcus Aureus:Do you know what you’re eating? Katheryn Bruton Walden University MPH program Environmental Health Pubh 6165-5 Instructor: Stephen Arnold Source: http://ssmmid.org/staphylococci/

2. 2 1 Source: http://howshealth.com/staph-skin-infections- pictures-causes-symptoms-and-treatment/ Source: http://howshealth.com/staph-skin-infections-pictures-causes-symptoms-and-treatment/ 4 3 Source: http://www. buzzle.com/articles/staphylococcal-food-poisoning.html Source: http://ssmmid.org/staphylococci/

3. Staphylococcus and Our Health An Overview Staphylococcus aureus Staphylococcus epidermidis Staphylococcus saprophyticus

4. Staph what?? Source - Fauci, Braunwald, et.al., 2008, p. 873 • One of the most common pathogens • Gram positive cocci that forms clusters • Exotoxins • Can live for a long time

5. Normal Human Flora Source: Microsoft Clip Art

6. Doctor, Doctor, I feel sick!! • Superantigens - Bind to MHC-II - Bind to T-cell receptor - Helprelease IL-2 and IFN-γ

7. TSST-1 • Fever • Nausea • Vomiting • Diarrhea • Rash • Muscle pain • Abdominal tenderness • Headache • Shock

8. Exfoliatin • Exfoliatin Toxin A (ETA) • Exfoliatin Toxin B (ETB) • Epidermal necrolysis

9. Exfoliatin cont… Source: http://www.jaskin.com/?p=485 King and Saint Victor, 2010, http://emedicine.medscape.com/article/788199-overview Source: King and Saint Victor, 2010, http://emedicine.medscape.com/article/788199-media • Staph Scalded Skin Syndrome (SSSS) • Rash and Bullae • Fever, chills, weakness • Separation of the epidermis/peeling • Hematogenously spread • Rapid progression

10. Food Poisoning!! Enough about Toxic shock and scalded skin, what happens if I have food poisoning??

11. Transmission  Food poisoning • Normal Flora • Human-human transmission • Wash your food and wash your hands!!

12. Enterotoxin Source – Personal photo from 2007 • Still an exotoxin • Released within the intestinal mucosa or basically in the gastrointestinal tract • Nausea, vomiting, diarrhea

13. Pathogenesis • Ingestion of toxin-contaminated food • Enterotoxin resistant to hydrolysis and heat-stable at 100°C

14. Single meal • Early symptoms (30 min, 1-6 hrs, 12 hrs) • Intoxications instead of infections • Severity • # of organisms • status of the host

15. Problematic Foods Source – Rattray, 2010, Southern Food • Ice cream • Egg salad • Ham • Potato salad • Salted pork • Pastries filled with custard • Mayonnaise • Sausages

16. Acute symptoms • Symptoms appear within 12 hrs • No fever • Vomiting > diarrhea

17. Prevention: What can I do?? • First and foremost, wash your hands!!  • People with skin infections should NOT prepare food • Proper refrigeration • Do not leave food at room temperature

18. By all means, cover your sneeze!! Source: Hazy, AD http://reddit.wired.com/submission_stop_action_photography/?s=top

19. Source: http://www.folksy.com/items/614361-CLEAR-ACRYLIC-PERSPEX-SNEEZE-GUARD-OR-FOOD-SCREEN • A sneeze guard

20. Treatment • Penicillin, clindamycin, cephalosporins?? • Rehydration • Rest • Loperamide aka Imodium D??

21. Government Regulations Centers for disease control and prevention Food and drug administration

22. Centers for Disease Control and Prevention CDC, 2010, Food Safety Office (FSO) http://www.cdc.gov/foodsafety/ • US Stats • 76 million illnesses • 300,000 hospitalized • > 5,000 die • Tracking is vital • Food Safety Office • Disability, sickness, and death • Interdepartmental, nation wide and international endeavors • Provides information and recommendations • Prevention and management • Liaisons with other US departments • Constant reviews and assessment

23. CDC cont… • Biological warfare • Enterotoxin B CDC. (2006). National Center for Immunization and Respiratory Diseases: Division of Bacterial Diseases. Retrieved from http://www.cdc.gov/ncidod/dbmd/diseaseinfo/staphylococcus_food_g.htm

24. Food and Drug Administration • Food protection plan • Prevention • Food facilities renewing registrations every 2 years • Overseas • Intervention • Inspections, sampling, risk • Imports • Response • Data collection, reporting and emergency response • Stakeholders • Media • Mandatory recall power FDA. (2009) http://www.fda.gov/Food/FoodSafety/FoodSafetyPrograms/FoodProtectionPlan2007/ucm132705.htm

25. Conclusion Handle your food properly & by all means Wash your hands

26. References • CDC, 2010, Food Safety Office (FSO) http://www.cdc.gov/foodsafety/ • Fauci, A., Braunwald, E., et.al. (2008). Harrison’s Principles of Internal Medicine 17th edition. New York: McGraw Hill. • FDA. (2009) http://www.fda.gov/Food/FoodSafety/FoodSafetyPrograms/FoodProtectionPlan2007/ucm132705.htm • Hazy, AD. Cover your Sneeze. Retrieved from http://reddit.wired.com/submission_stop_action_photography/?s=top • King, R. and Saint Victor, P. (2010). Staphylococcal Scalded Skin Syndrome. Emedicine. Retrieved from http://emedicine.medscape.com/article/788199-overview • Rattray, D. (2010). Southern Food - Potato Salad with Peas. Image retrieved from http://southernfood.about.com/od/potatorecipes/ig/Potato-Salads/potatosalad-peas-3.htm

27. Thank you!! Questions, Comments, Observations??