A Review of Outbreaks of Foodborne Disease Associated with Passenger Ships: Evidence for Risk Management

Abstract

Objective. Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation.Methods. The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected.Results. The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks.Conclusions. Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work.

Staphylococcus aureus Contamination during Food Preparation, Processing and Handling

“…S. aureus is found in nasal passages, throat, hair and skin of carriers [2]. Food is usually contaminated from nasal secretions, sneezing, coughing and direct hand contact of infected carriers [4], [5].…”

“…S. aureus is found in nasal passages, throat, hair and skin of carriers [2]. Food is usually contaminated from nasal secretions, sneezing, coughing and direct hand contact of infected carriers [4], [5].Three categories of S. aureus carriers have been Manuscript received November 9, 2013; revised February 21, 2014 recognized: persistent, intermittent (occasional) and never-carriers. Persistent carriers are infected with the same staphylococcal strain for months or even years.…”

Survival of Biofilm-Forming Salmonella on Stainless Steel Bolt Threads under Dry Conditions

“…Non typhoid Salmonella (NTS) strains are among the most important foodborne bacteria 1) ῌ Outbreaks of foods poisoning have frequently occurred as a result of the consumption of NTS-contaminated foods and food products 2) ῌ NTS cannot grow under dry conditions of A w below 0.94, but many studies show that NTS can survive for a long time under dry conditions. For example, S. enterica subsp.…”

Multiplexed Bead-Based Mesofluidic System for Detection of Food-Borne Pathogenic Bacteria

“…The Food and Drug Administration's 2005 Food Code states that the estimated cost of food-borne illness is $10 billion to $83 billion annually (29). The major food-borne pathogens include Salmonella, Listeria monocytogenes, Staphylococcus aureus, Vibrio parahaemolyticus, Campylobacter jejuni, Escherichia coli O157:H7, Enterobacter sakazakii, and Shigella (14,32,41).Rapid detection and identification of pathogens and other microbial contaminants in food are needed by the food industry, food safety agencies, and public health bureaus. Traditional methods to detect food-borne bacteria often rely on time-consuming growth in culture media, isolation of bacteria, biochemical identification, and sometimes serology (5, 8).…”

“…The Food and Drug Administration's 2005 Food Code states that the estimated cost of food-borne illness is $10 billion to $83 billion annually (29). The major food-borne pathogens include Salmonella, Listeria monocytogenes, Staphylococcus aureus, Vibrio parahaemolyticus, Campylobacter jejuni, Escherichia coli O157:H7, Enterobacter sakazakii, and Shigella (14,32,41).…”