Diarrheal diseases are a significant global health problem; they are the largest

contributor to waterborne disease burden worldwide. Among the wide spectrum of diseases that
are associated with food and especially water, gastroenteritis is the most commonly identified
illness. These diarrheal diseases contribute to as many as 4 million cases annually and 1.8
million deaths. Of these cases, 88% can be linked to poor water quality (World Health
Organization, 2009).

Food- and water-borne illnesses may be caused by toxins created by growing bacteria;
toxins produced by the harmful algal species; or contamination of food and/or water with certain
bacteria, viruses or parasites. Food- or water-borne illnesses are not spread from casual contact
with another person. A person can come into contact with food- or water-borne bacteria by
eating or drinking something that contains the pathogen. Most infections with food- and waterborne bacteria cause diarrhea, nausea, vomiting, fever and stomach cramps. Severity depends
on host and agent characteristics and the infectious dose. Hospitalisation and death may occur
due to acute dehydration, metabolic acidosis and subsequent organ failure. When investigating
a possible food borne disease outbreak epidemiologists collect information about each
individuals food history, incubation period, signs and symptoms and duration of illness. A food
history is important since most food borne diseases take anywhere from several hours to days
or even weeks before symptoms may occur. The incubation period is measured from the time
contaminated food is consumed to the first signs and symptoms. All of this information assists
an epidemiologist in determining what type of organism caused an outbreak.

Bacteria are single celled organisms that need moisture, temperature, and food to grow
and multiply. All of these conditions are present in potentially hazardous food. Foods that are
potentially hazardous include raw and cooked meat (fish, beef, pork, poultry, sheep, etc.),
cooked vegetables, cooked grains, dairy products, and whole fresh eggs. Given that all of these
foods can support the growth of disease causing bacteria, they must be held at and cooked to
proper temperatures to prevent disease.
BACTERIAL AGENTS:

toxin produced in food:

Staphylococcus aureus

damage to gut wall and/or systemic infection:

Salmonella spp.

Shigella spp.

E. coli.

Helicobacter pylori

Vibrio cholerae/V. parahaemolyticus

S.typhi/Paratyphi

Viruses are infectious agents that can be found inside cells (Figure A). They infect a host
by attaching to a cell, dissolving a small section of the cell wall and invading the cell through this
opening.
VIRAL AGENTS:
Hepatits A
Norwalk Virus
Rotavirus

Prevention of the contamination of potable water is very important. Contaminated water should
be treated by adequate filtration and disinfection or by boiling. Avoiding contamination of food is
also important.