Food borne illnesses

[See also Food poisoning]
ORGANISM (COMMON NAME OF ILLNESS) TIME FROM INGESTION TO SYMPTOM ONSET SIGNS AND SYMPTOMS DURATION FOOD SOURCES RECOMMENDED REGIMEN FOR ADULTS RECOMMENDED REGIMEN FOR CHILDREN
Bacillus cereus (food poisoning) 10 - 16 hr Abdominal cramps, nausea, watery diarrhea 24 to 48 hrs Gravy, meats, stews, vanilla sauce No treatment No treatment
Campylobacter jejuni(campylobacteriosis) 2 to 5 days Abdominal cramps, diarrhea (may be bloody), fever, vomiting 2 to 10 days Contaminated water, raw or undercooked poultry, unpasteurized milk Erythromycin, 500 mg 2 times per day for 5 days
or
Azithromycin (Zithromax), 500 mg on day 1, then 250 mg on days 2 through 5
Azithromycin, 10 mg per kg per day for 3 to 7 days
Clostridium botulinum (botulism) 12 to 72 hrs Blurred vision, diarrhea, difficulty swallowing, double vision, muscle weakness, vomiting; can cause respiratory failure and death Variable Fermented fish, improperly canned foods (especially home-canned vegetables), potatoes baked in aluminum foil Polyvalent antitoxin/Penicillin/Colonic lavage Polyvalent antitoxin/Penicillin/Colonic lavage
Clostridium perfringens (food poisoning) 8 to 16 hrs Intense abdominal cramps, watery diarrhea Usually 24 hrs Dried or precooked foods, gravy, meats, poultry, undercooked foods    
Cyclospora cayetanensis(cyclosporiasis) 1 to 14 days, usually at least 1 week Abdominal cramps, diarrhea (usually watery), fatigue, loss of appetite, nausea, substantial weight loss, vomiting May be remitting and relapsing over weeks to months Contaminated raw produce (e.g., basil, imported berries, lettuce)    
Escherichia coli(traveler's diarrhea) 1 to 3 days Abdominal cramps, vomiting, watery diarrhea 3 to 7 days Food or water contaminated with human feces Ciprofloxacin, 500 mg 2 times per day for 3 days
or
TMP/SMX, 160/800 mg 2 times per day for 3 to 7 days*
or
Azithromycin, 500 mg on day 1, then 250 mg on days 2 through 5
TMP-SMX, 5/25 mg per kg 2 times per day for 3 days*
or
Azithromycin, 10 mg per kg per day for 3 to 7 days
E. coli O157:H7 (Shiga toxin–producing E. coli or hemorrhagic colitis) 1 to 8 days Abdominal pain, severe diarrhea (often bloody), vomiting; can cause kidney failure 5 to 10 days Contaminated drinking water, contaminated raw produce (e.g., sprouts), undercooked beef (especially hamburger), unpasteurized milk or juice Not recommended Not recommended
Hepatitis A 15 to 50 days (mean = 28 days) Abdominal pain, dark urine, diarrhea, fever, headache, jaundice, nausea 2 weeks to 3 months Contaminated drinking water, contaminated raw produce, cooked foods that are not reheated after contact with an infected food handler, shellfish from contaminated water, uncooked foods    
Listeria monocytogenes(listeriosis) 9 to 48 hrs for gastrointestinal symptoms, 2 to 6 weeks for invasive disease Diarrhea, fever, muscle aches, nausea; pregnant women may have mild flulike illness, and infection can lead to premature delivery or stillbirth; older adults and immunocompromised patients may develop bacteremia or meningitis Variable Deli meats, unpasteurized milk, soft cheeses made with unpasteurized milk    
Norovirus (food poisoning, viral gastroenteritis, winter diarrhea) 12 to 48 hrs Abdominal cramps, diarrhea (more common in adults), fever, headache, nausea, vomiting (more common in children) 12 to 60 hrs Contaminated drinking water, contaminated raw produce, cooked foods that are not reheated after contact with an infected food handler, shellfish from contaminated water, uncooked foods    
Salmonella(salmonellosis) 6 to 48 hrs Abdominal cramps, diarrhea, fever, vomiting 4 to 7 days Cheese, contaminated raw produce, eggs, meat, poultry, unpasteurized milk or juice Generally not recommended
If indicated:
Ciprofloxacin, 500 mg 2 times per day for 5 to 7 days
or
Azithromycin, 500 mg on day 1, then 250 mg on days 2 through 5
or
Ceftriaxone, 1 to 2 g per day intramuscularly or intravenously for 5 to 7 days
Generally not recommended
If indicated:
TMP-SMX, 5/25 mg per kg 2 times per day for 5 to 7 days
or
Azithromycin, 10 mg per kg per day for 3 to 7 days
or
Ceftriaxone, 50 to 100 mg per kg per day intramuscularly or intravenously for 5 to 7 days
Shigella (shigellosis or bacillary dysentery) 4 to 7 days Abdominal cramps, diarrhea, fever; stools may contain blood and mucus 24 to 48 hrs Contaminated drinking water, contaminated raw produce, cooked foods that are not reheated after contact with an infected food handler, uncooked foods Ciprofloxacin, 500 mg 2 times per day for 3 days
or
Azithromycin, 500 mg on day 1, then 250 mg on days 2 through 5
TMP-SMX, 5/25 mg per kg 2 times per day for 3 days
or
Azithromycin, 10 mg per kg per day for 3 to 7 days
Staphylococcus aureus (food poisoning) 1 to 6 hrs Abdominal cramps, diarrhea, fever, sudden onset of severe nausea and vomiting 24 to 48 hrs Unrefrigerated or improperly refrigerated cream pastries, meats, and potato or egg salad    
Vibrio parahaemolyticus 4 to 96 hrs Abdominal cramps, fever, nausea, vomiting, watery diarrhea (occasionally bloody) 2 to 5 days Undercooked or raw seafood    
Vibrio vulnificus 1 to 7 days Abdominal pain, bleeding under the skin, bloodborne infection, diarrhea, fever, ulcers requiring surgical removal, vomiting; can be fatal to persons with liver disease or weakened immune systems 2 to 8 days Undercooked or raw seafood (especially oysters)    
Parasites
Cryptosporidium(cryptosporidiosis) 2 to 10 days Abdominal cramps, diarrhea (usually watery), slight fever

Severe diarrhea in AIDS
May be remitting and relapsing over weeks to months Contaminated drinking water, cooked foods that are not reheated after contact with an infected food handler, uncooked foods Generally not recommended

Nitazoxanide in immunocompetent hosts
Generally not recommended
Entamoeba Histolytica   Bloody diarrhea (dysentery), liver abscess (“anchovy paste” exudate), RUQ pain (histology shows flask-shaped ulcer if submucosal abscess of colon ruptures)     Metronidazole (Flagyl), 750 mg 3 times per day for 5 to 10 days
PLUS
Paromomycin, 500 mg 3 times per day for 7 days, or iodoquinol (Yodoxin), 650 mg 3 times per day for 7 days
Metronidazole, 30 to 50 mg per kg per day in 3 divided doses for 7 to 10 days
PLUS
Paromomycin, 25 to 35 mg per kg per day in 3 divided doses for 5 to 10 days
Giardia   Bloating, flatulence,
foul-smelling, fatty diarrhea
 
  (often seen in campers/hikers)— think fat-rich Ghirardelli chocolates for fatty stools of Giardia Metronidazole, 250 to 750 mg 3 times per day for 7 to 10 days Metronidazole, 30 to 50 mg per kg per day in 3 divided doses for 7 to 10 days