Water and Foodborne Diseases Overview

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Questions and Answers

What is the primary infectious agent responsible for cholera?

  • Escherichia coli
  • Salmonella enterica
  • Shigella dysenteriae
  • Vibrio cholerae (correct)

What are common symptoms of waterborne diseases?

  • Diarrhea, nausea, abdominal pain, fever (correct)
  • Skin rash and muscle pain
  • Chest pain, coughing, and fatigue
  • Headache, sore throat, and fever

What type of diarrhea is characteristic of severe cholera cases?

  • Foamy diarrhea
  • Rice water diarrhea (correct)
  • Green watery diarrhea
  • Blood-stained diarrhea

Which organism is a common fecal coliform?

<p>Escherichia coli (A)</p> Signup and view all the answers

Which serotype of Vibrio cholerae is associated with the ongoing seventh pandemic?

<p>O1 El Tor (A)</p> Signup and view all the answers

What is the mortality rate for cholera patients with treatment?

<p>20% (A)</p> Signup and view all the answers

What is the Most Probable Number (MPN) method primarily used for?

<p>Estimating cell number based on bacterial growth (A)</p> Signup and view all the answers

What is the main mode of transmission for cholera?

<p>Fecal-oral route (C)</p> Signup and view all the answers

Which component is NOT typically included in selective and differential media for coliform testing?

<p>Steroids (B)</p> Signup and view all the answers

What is a primary prevention strategy for waterborne diseases?

<p>Wastewater treatment and water purification (B)</p> Signup and view all the answers

Which of the following treatment methods is critical for managing severe cases of cholera?

<p>Water and electrolyte replacement (C)</p> Signup and view all the answers

What is the virulence factor that mediates the pathogenicity of Vibrio cholerae?

<p>Cholera toxin (D)</p> Signup and view all the answers

Fecal coliforms are derived from which source?

<p>The gut of warm-blooded animals (D)</p> Signup and view all the answers

Which procedure is used to test water samples for fecal coliforms?

<p>Membrane filter method (C)</p> Signup and view all the answers

Where is cholera considered endemic?

<p>Southern Asia (D)</p> Signup and view all the answers

Cholera and Typhoid are classified under which category of diseases?

<p>Waterborne diseases (C)</p> Signup and view all the answers

What is the primary infectious agent responsible for Typhoid Fever?

<p>Salmonella enterica serotype typhi (C)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with Typhoid Fever?

<p>Coughing (B)</p> Signup and view all the answers

What is the estimated mortality rate of Typhoid Fever when antibiotic treatment is provided?

<p>1-4% (D)</p> Signup and view all the answers

Which method is identified as the best prevention strategy for an outbreak of Typhoid Fever?

<p>Improve sanitation and potable water (C)</p> Signup and view all the answers

What is the role of Salmonella pathogenicity island 7 in Typhoid Fever?

<p>Encodes genes for virulence factors (C)</p> Signup and view all the answers

What genetic disorder is commonly associated with mutations in the CFTR protein?

<p>Cystic Fibrosis (B)</p> Signup and view all the answers

How is Typhoid Fever primarily transmitted?

<p>Fecal-oral route (A)</p> Signup and view all the answers

Which of the following describes the impact on mucus in the airways of a patient with Cystic Fibrosis?

<p>Mucus becomes thick due to hypertonic airway cells (B)</p> Signup and view all the answers

What is the estimated economic burden of major foodborne illnesses in the United States per year?

<p>$15.5 billion (A)</p> Signup and view all the answers

Which age group was significantly affected in the 1903 Ithaca Typhoid outbreak?

<p>Incoming class of college students (B)</p> Signup and view all the answers

What percentage of infected individuals may develop a chronic asymptomatic infection in the gall bladder?

<p>3-5% (A)</p> Signup and view all the answers

Which characteristic is true about Listeria monocytogenes?

<p>It can survive outside the human body but can also be an opportunistic pathogen. (C)</p> Signup and view all the answers

What is a common response of a Cystic Fibrosis patient when infected with cholera?

<p>They have the same susceptibility and experience diarrhea. (A)</p> Signup and view all the answers

Flashcards

Cystic Fibrosis

A genetic disorder affecting roughly 1 in 2,500 people, caused by mutations in the CFTR protein. This results in thick mucus accumulation in the lungs and other organs, leading to breathing difficulties and digestive issues.

CFTR protein

A protein responsible for transporting chloride ions across cell membranes, particularly in the lungs. Mutations in this protein lead to Cystic Fibrosis.

Vibrio cholerae

A bacterium responsible for causing cholera, a severe diarrheal disease. It is commonly found in contaminated water and food.

Listeria monocytogenes

An opportunistic pathogen that can cause foodborne illness. It is found in various environments and can survive outside the human body. Listeria can even cross the blood-brain barrier and placental barrier, posing a risk to pregnant women and newborns.

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Altering the cytoskeletal machinery during infection

A process where a pathogen utilizes the host cell's cytoskeletal machinery to its advantage during the infection process.

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Typhoid Fever

A bacterial infection caused by Salmonella enterica serotype Typhi, primarily spread through contaminated food and water.

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Humans

The main reservoir of typhoid fever, responsible for the spread of the infection.

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Fecal-Oral Transmission

The primary means of transmission for typhoid fever; involves ingestion of contaminated materials.

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Vi-capsule Antigen

A bacterial capsule produced by Salmonella enterica serotype Typhi, that helps it evade the host's immune system.

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Selective & Differential Media

A type of selective and differential media used to detect Salmonella bacteria, including those responsible for typhoid.

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Wastewater Treatment & Water Purification

A crucial preventative measure for typhoid, involving proper sanitation and water treatment.

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Typhoid Vaccine

One of the effective ways to prevent typhoid infection; however, it's not 100% effective.

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Antibiotic Resistance

A concerning factor in typhoid treatment, where certain strains have developed resistance to common antibiotics.

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Coliforms

A group of intestinal bacteria, including fecal coliforms (from warm-blooded animals) and Escherichia coli (E. coli). These bacteria are used as indicators of fecal contamination in water.

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Waterborne Diseases

A general term for infections acquired from contaminated water. These infections often involve the digestive system and cause symptoms like diarrhea, nausea, abdominal pain, and fever.

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Fecal Coliforms

A type of coliform found in the gut of warm-blooded animals, indicating fecal contamination in water.

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Escherichia Coli (E. coli)

E. coli is a common type of fecal coliform. It is commonly found in the intestines of humans and other warm-blooded animals. Its presence in water samples indicates fecal contamination.

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Most Probable Number (MPN) Method

A method for testing fecal contamination in water using a selective and differential media. Diluted water samples are inoculated into multiple tubes, and the number of tubes showing bacterial growth is used to estimate the concentration of bacteria in the original sample.

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Membrane Filter (MF) Method

A method to quantify fecal contamination in water by filtering a specific volume of water through a membrane filter and growing the captured bacteria on a selective and differential medium.

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EMB Agar

A type of agar medium used to isolate and identify coliform bacteria. It contains lactose as a sugar source, a pH indicator that changes color upon acid production, and an inhibitor that prevents the growth of Gram-positive bacteria.

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Potable Water

Water that is safe for human consumption. It is free of harmful bacteria, viruses, and parasites and meets specific quality standards.

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Cholera

Cholera is a diarrheal disease caused by Vibrio cholerae. It is characterized by severe, watery diarrhea, sometimes referred to as 'rice water diarrhea'. Untreated, it can be fatal. Fortunately, rehydration therapy and antibiotics can effectively reduce mortality rates.

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Cholera Epidemiology

Cholera is rare in developed countries but is endemic in Southern Asia. Pandemic outbreaks have caused millions of cases and tens of thousands of deaths worldwide.

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Cholera Transmission

Cholera transmission occurs through the fecal-oral route, mainly via contaminated water. This means infected feces contaminate water sources, which are then consumed and lead to infection.

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Cholera Toxin

The cholera toxin (CT) is a crucial virulence factor, an AB exotoxin encoded by the ctxAB gene found on a bacteriophage called CTXφ. This toxin disrupts the normal function of intestinal cells, leading to severe diarrhea.

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Toxin Co-regulated Pilus (TCP)

The Toxin Co-regulated Pilus (TCP) acts as a colonization factor crucial for Vibrio cholerae to attach to and form biofilms in the intestines, also serving as a receptor for CTXφ. It enhances the bacterium's ability to survive and cause infection.

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CTXφ Bacteriophage

CTXφ is a lysogenic, filamentous bacteriophage that carries the ctxAB gene for cholera toxin. It infects Vibrio cholerae strains, enabling them to produce the toxin and cause severe disease.

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CTXφ and Epidemics

Only Vibrio cholerae strains carrying CTXφ are capable of causing epidemic cholera. This highlights the essential role of the bacteriophage in the severe and widespread nature of the infections.

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Study Notes

Waterborne Diseases

  • Waterborne diseases are illnesses transmitted through contaminated water.
  • Common waterborne diseases include: water treatment issues, fecal coliforms, typhoid, and cholera.
  • Gastroenteritis, common symptoms include diarrhea, nausea, abdominal pain, and fever. About 1.8 million deaths annually worldwide are caused by fecal-oral transmission.

Foodborne Diseases

  • Common foodborne diseases include Listeria.
  • A wide variety of bacteria, protozoa, and viruses are responsible
  • Water treatment: includes removing large particles, coagulation, filtration, and chlorination, to produce safe drinking water.

Fecal Coliforms

  • Coliforms are a generic term for Gram-negative, non-sporulating, facultative aerobic rods.
  • Fecal coliforms are present in the gut of warm-blooded animals.
  • Escherichia coli is a common fecal coliform.
  • Water and recreational water are routinely tested for coliforms as indicator organisms.
  • A medium for selective and differential coliforms may include lactose, a pH indicator, and antimicrobials that inhibit Gram-positives.

Membrane Filter (MF) Method

  • Testing for fecal coliforms and E. coli can be done using a membrane filter method.
  • A sample of 100 ml water is filtered through a membrane.
  • The membrane is then placed on a selective and differential medium.
  • The number of colony-forming units (CFUs) per 100 ml of water is determined.

EMB Agar

  • EMB agar is selective and differential for coliforms.
  • It includes lactose, an inhibitor of Gram-positive bacteria, and a pH indicator.
  • The fermentation of lactose produces acid, changing the color of the medium.

Most Probable Number (MPN) Method

  • The MPN method is used for testing fecal coliforms and E. coli.
  • The water sample is diluted.
  • The diluted sample is inoculated into tubes containing a selective and differential medium.
  • The number of tubes that grow bacteria is used to estimate the cell number.

Typhoid Fever

  • Infectious agent: Salmonella enterica serotype Typhi
  • Epidemiology: Rare in developed nations, endemic in much of Asia (~21 million cases and 161,000 deaths in 2013, according to WHO).
  • Reservoir: Humans are the main reservoir.
  • Transmission: Fecal-oral, contaminated water.
  • Symptoms: High fever, abdominal pain, symptoms last weeks-months (25% mortality without treatment, 1–4% with antibiotic treatment).Chronic asymptomatic infection occurs in the gall bladder.

Typhoid Fever - 1903 Ithaca Outbreak

  • Ithaca, New York lacked secure water supply/ filtration.
  • 10–15% of incoming students experienced 'freshman diarrhea.'
  • 1350 cases (10% population) and 82 deaths (29 Cornell students)

Listeriosis

  • Agent: Listeria monocytogenes, Gram-positive bacteria.
  • Found in soil, water, and the intestinal tracts of diverse mammals (and birds). (5-10% are carriers with no sign of disease.)
  • Transmission: In foodborne outbreaks.
  • Transmission source: dairy products, meats (ready to eat).
  • able to survive freezing, excessive heat, and drying. Also, thrives in refrigerators (Psychrotolerant.)
  • Symptoms: Fever, muscle aches, sometimes diarrhea or other GI symptoms.
  • Susceptible individuals can have invasive disease (inflammation of intestinal tract, septicemia, meningitis, encephalitis).
  • Pregnant women can experience miscarriage, life-threatening infections.
  • Epidemiology (in US): ~1600 cases annually, 260 fatalities.

Cholera

  • Agent: Vibrio cholerae, Gram-negative bacteria.
  • Found in coastal habitats, lives on zooplankton and crustaceans.
  • More than 200 serotypes, few cause disease (01, 01 El Tor, 0139 – 5th, 6th, 7th, 8th pandemics, respectively).
  • Vibrio cholerae can be found on copepods.
  • Reservoir: Coastal habitats (endemic) and humans (pandemic).
  • Symptoms: Diarrhea (often mild), 2-3 days to onset. 10–20% of cases are severe (up to 20 L per day of rice water diarrhea). 50–60% mortality without treatment, 20% mortality with treatment.
  • Epidemiology (worldwide): Rare in developed nations, endemic in Southern Asia, and pandemics of cholera (3–5 million cases annually with >100,000 deaths).
  • Virulence factor: Cholera toxin (CT, an AB exotoxin). Aids entry into host cells by endocytosis and lysing phagosomes (Cytotoxin LLO).
  • Prevention: Wastewater treatment & Water Purification, simple filtration (e.g. sari cloth). Detection: Differential media

Foodborne Illness in the US

  • Roughly 1 in 6 Americans (48 million) gets sick each year, with 128,000 hospitalizations and 3,000 deaths.
  • Norovirus outbreaks in hospitals and cruise ships cost about $2 billion per year.
  • The economic burden of major foodborne illnesses in the US in 2015 was estimated at $15.5 billion.

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