Vet Public Health Midterm

Front 1

what is the causative agent of stomach flu in people?

Back 1

norovirus

Front 2

what agent causes Typhoid in people?

Back 2

Salmonella typhi

Front 3

what are the top 5 pathogens that cause food-borne illness in people?

Back 3

1. Norovirus (stomach flu)
2. Salmonella (non-typhoidal)
3. Clostridium perfringens
4. Campylobacter
5. Staphylococcus aureus

Front 4

What are the top 5 food-borne pathogens that cause hospitalization in people?

Back 4

1. Salmonella (non-typhoidal)
2. Norovirus
3. Campylobacter
4. Toxoplasma gondii (usually from undercooked meat)
5. E. coli (STEC) O:157

Front 5

what is the main source of toxoplasma gondii infection in people?

Back 5

undercooked meat

Front 6

where are Vibrio species that cause food-borne illness found?

Back 6

shellfish

Front 7

What are some human demographic contributors to food-borne illness?

Back 7

- ↑ immunocompromised people: age (chronic dz), HIV, chemotherapy, organ transplants
- eating habits: convenience, fresh produce, where food is eaten, food safety instruction

Front 8

what percent of:
- meals are consumed outside the home?
- food-borne illness outbreaks occurred outside the home?

Back 8

- 40% meals outside home
- 80% of outbreaks outside the home

Front 9

what are three changes in industry that have contributed to food safety concerns?

Back 9

1. ↑ geographic distribution of products from large, centralized food processors
2. ↑ ability to detect organisms
3. changes in food processing and production technologies (large plants, larger farms, integration)

Front 10

what are four changes in travel and commerce that have contributed to food safety concerns?

Back 10

1. foods brought into the country
2. food eaten in a foreign country or plane during international travel
3. internationally distributed foods - not as good QA/QC
4. ethnic groups that have immigrated to the US (e.g. Mexican immigrants eating unpasteurized Mexican cheese)

Front 11

what are two ways that microbes have adapted that cause concern and an increase in the number of food-borne illness cases?

Back 11

1. bacteria developing resistance to natural control methods, heat, or acid
2. some bacteria have adapted to specific hosts (e.g. S. enteritidis in eggs)

Front 12

what are three changes in economic development and land use that have impacted food-borne illness?

Back 12

1. ↑ manure use (1.6 billion tons)
2. fecal runoff
3. shift from cold season harvesting of oysters to year round harvesting

Front 13

what is the major cause of outbreaks of food-borne illness

Back 13

improper handling of food

Front 14

what are the top 5 ways that food is improperly handled as to cause food-borne illness

Back 14

1. improper holding temperature
2. inadequate cooking
3. poor personal hygiene
4. contaminated equipment
5. food from an unsafe source

Front 15

what are five factors essential for food-borne bacterial disease to occur?

Back 15

1. presence of pathogenic bacteria or bacterial toxin
2. source of contamination
3. a medium for the bacteria to grow in
4. proper environmental relationships
5. consumption of sufficient quantity (toxic dose)

Front 16

what are the proper holding temperatures to prevent food-borne illness

Back 16

< 40 °F and > 140 °F

Front 17

adequate cooking of food:
- to kill bacteria
- to kill spores
- pasteurization temp and times

Back 17

- cook at 145°F and higher
- spores: cook at 212 °F for 30 minutes
- pasteurize: 145 °F for 30 minutes or 161 °F for 15 seconds

Front 18

what is the definition of "food borne infection?"

Back 18

replication of organisms AFTER ingestion

Front 19

what is the definition of "food borne intoxication?"

Back 19

ingestion of pre-formed toxins (e.g. bacteria grows BEFORE ingestion)

Front 20

what does HACCP stand for?

Back 20

Hazard Analysis and Critical Control Point system

Front 21

what is the purpose of a Hazard Analyses and Critical Control Point system (HACCP)?

Back 21

determine the food safety hazards reasonably likely to occur and identify the preventative measures the plant/production unit can apply to control the hazards

Front 22

what are the seven steps of a Hazard Analysis and Critical Control Point system (HACCP)?

Back 22

1. conduct hazard analysis - find where hazards could occur
2. identify critical control points
3. establish critical limits for each control point
4. monitor these control points
5. establish corrective actions of control points are not performed
6. establish record keeping procedures
7. establish procedures to verify HACCP is working

Front 23

what are three ways to prevent contamination of food?

Back 23

1. proper personal hygiene
2. clean equipment
3. unadulterated ingredients

Front 24

what is the most common Salmonella isolate in food? From where is the contamination thought to originate?

Back 24

- S. typhimurium
- fecal contamination at time of harvesting
- rodents thought to be a source

Front 25

which Salmonella isolate is associated with milk? How does this bacteria affect dairy cows?

Back 25

- S. dublin
- host-adapted to cattle
- infected cows asymptomatic, but periodically shed in milk and feces

Front 26

which Salmonella isolate is associated with poultry and eggs?

Back 26

- S. enteritidis

Front 27

In what type of gourmet setting are Salmonella enteritidis outbreaks associated?

Back 27

In cafeterias where large amounts of eggs are pooled together

Front 28

what is the incubation period for Salmonellosis in humans?

Back 28

8-72 hours

Front 29

what is the most common infectious agent from bite wounds that requires hospitalization?

Back 29

Pasteurella multocida

Front 30

what are human patient risk factors for hospitalization from a bite wound? (7)

Back 30

1. > 50 years old
2. puncture wounds that cannot be thoroughly cleansed
3. bites on the hands (hands are avascular → anaerobes)
4. delay in > 24 hours before seeking treatment
5. inadequate wound care
6. diabetes
7. splenectomy

Front 31

as a vet, what are 5 things to do if a person is bitten by an animal?

Back 31

1. wash wound thoroughly
2. check rabies status of animal involved
3. suggest medical attention, especially if pain and redness becomes worse
4. call health department - required in some localities
5. high risk individuals instructed to seek medical attention

Front 32

DF-2?
- what is it?
- genus and species
- where found
- virulence
- how is it acquired?

Back 32

- "Dysgonic Fermentor" - a Gram-negative thin rod
- Capnocytophaga canimorsus
- found in oral cavity of dogs, cats, and ruminants
- virulent to immunosuppressed individuals, alcoholics, splenectomized individuals
- acquired by dog bites

Front 33

what are symptoms of DF-2 (Capnocytophaga canimorsus)? How do you prevent a bite wound from becoming infected in immunocompromised individuals?

Back 33

- inapparent in dogs, humans develop a Gram-negative sepsis; bacterium has tropism for endocardium and vascular endothelium
- prophylactic antibiotics for dog bites in at risk individuals

Front 34

what causes Cat Scratch Fever? What is the pathogen's morphology?

Back 34

- Bartonella henselae
- small, pleomorphic gram-negative bacillus

Front 35

how common is Bartonella henselae in normal cats?

Back 35

25-41%

Front 36

how is Bartonella henselae (cat scratch fever) acquired by humans? (4)

Back 36

- cat bites
- cat scratches
- cat licking your wounds
- possibly dog bites

Front 37

what age group of human primates are most susceptible to bite wounds?

Back 37

children

Front 38

describe the symptoms of cat scratch fever (Bartonella henselae) in immunocompetent people.

Back 38

- usually benign, self-limiting disease; lasts for several months
- tender regional lymphadenopathy without lymphangitis
- skin pustule/papule → lymphadenitis
- if lymphadenitis, usually unilateral and suppurative
- < 30% develop malaise, fever, headache, sore throat, splenomegaly, vomiting, stomach cramps.

Front 39

what is a potential serious sequela to cat scratch fever in immunocompromised individuals?

Back 39

Bacillary Angiomatosis - proliferation of small blood vessels in skin and visceral organs in immunocompromised individuals

Atypical manifestations: tonsillitis, encephalitis, cerebral arteritis, granulomatous hepatitis, pneumonia, thrombocytopenic purpura

Front 40

what is an atypical complication of cat scratch fever?

Back 40

(Bartonella henselae)
chronic fistulous tracts

Front 41

how is cat scratch fever treated in people?

Back 41

(Bartonella henselae)
- aspiration of lymph nodes
- doxycycline, erythromycin, and rifampin
- cull

Front 42

how is cat scratch fever diagnosed?

Back 42

- rule out lymphadenopathies
- serology and PCR for definitive Dx

Front 43

what are four ways to prevent cat scratch fever?

Back 43

1. clean all scratches or bite wounds thoroughly
2. avoid cat saliva, especially on open wounds
3. flea control
4. wash hands after handling cats

Front 44

sporotrichosis
- species in cats
- how do cats get it?
- how do humans get it?

Back 44

- Sporothrix schenckii
- cats: penetrating wound or (rarely) inhalation from soil
- humans: from draining lesions and feces of infected cats. No skin barrier compromise is necessary

Front 45

sporotrichosis:
- lesions in cats
- lesions in humans

Back 45

- cats: extremities, head, and base of tail: small, draining puncture wounds, proceeding to cavitated ulcers with seropurulent exudate. ± lymph node involvement
- humans: ulcerated skin nodules and painful lymphadenopathy

Front 46

how is sporotrichosis treated? (3)

Back 46

1. iodides
2. ketoconazole
3. Amphotericin B

Front 47

how is zoonotic transmission of sporotrichosis from cats prevented?

Back 47

- wear exam gloves when draining lesions in cats
- proper cleaning of hands and equipment

Front 48

where is there currently an epidemic of Mycobacterium bovis?

Back 48

in Michigan white-tailed deer, which has spilled over into the cattle population

Front 49

what are four wild carriers of Mycobacterium bovis?

Back 49

1. white-tailed deer (Michigan)
2. bear
3. coyote
4. raccoon

Front 50

which tuberculosis agent is prevalent in AIDS patients?

Back 50

Mycobacterium avium/intracellulare complex (MAC), which includes M. avium ss paratuberculosis.

Front 51

which bacteria may have a link with Crohn's Disease?

Back 51

Mycobacterium paratuberculosis

Front 52

in what things that people routinely handle is Mycobacterium paratuberculosis found?

Back 52

1. pasteurized milk
2. muscle of infected animals
- i.e., humans may acquire from milk and meat

Front 53

why do we care about Mycobacterium marinum?

Back 53

immunocompromised individuals can get it from aquariums and fish

Front 54

where is Mycobacterium tuberculosis most commonly found?

Back 54

prisons

Front 55

what are symptoms of tuberculosis in humans? (3)

Back 55

- papules → non-healing painless ulcer with lymphadenopathy ("tuberculous chancre")
- pulmonary lesions: chronic pneumonia, wasting, cervical lymphadenitis (Mozart died of this)
- disseminated TB: genitourinary infection, bone and joint involvement, meningitis

Front 56

what is the histopathology of Mycobacterium lesions? Why?

Back 56

granulomatous, because they are intracellular pathogens

Front 57

how is Mycobacterium infection diagnosed?

Back 57

intradermal tuberculin test

Front 58

what are two drugs used to treat tuberculosis?

Back 58

isoniazid and rifampin

Front 59

what are 3 ways to prevent zoonotic spread of Mycobacteria?

Back 59

1. pasteurize milk
2. TB testing of animal populations and cull
3. wear gloves when handling infected animals

Front 60

what are 4 other names for brucellosis?

Back 60

1. Undulant Fever
2. Malta Fever
3. Gibraltar Fever
4. Bangs disease

Front 61

what are 6 species of Brucella, their animal hosts, and zoonotic potential?

Back 61

1. B. abortus - cow; zoonotic
2. B. suis - pigs, reindeer; zoonotic
3. B. canis - dogs; ??
4. B. melitensis - small ruminants; zoonotic and nasty
4. B. ovis - sheep; not zoonotic
5. B. neotomae - ??; not zoonotic

Front 62

what are two ways to get brucellosis in the US?

Back 62

1. eat non-pasteurized Mexican cheese (especially goat milk)
2. from bison in Yellowstone

Front 63

what are four basic ways for people to acquire brucellosis?

Back 63

1. directly: contact with fetal fluids and aborted tissue
2. indirectly: ingestion of animal products (e.g., milk inhalation during slaughter procedure)
3. accidental injection with strain 19 vaccine (RB51??)
4. marine

Front 64

what are symptoms of brucellosis in people?

Back 64

- septicemia with sudden or insidious onset with continuous, intermittent, or irregular fever
- Chills, profuse sweating, high temperatures
- irritable, nervous, depressed
- muscular weakness and exercise intolerance
- lymph node enlargement, splenomegaly, hepatomegaly

Front 65

what are 5 complications from brucellosis in people?

Back 65

1. encephalitis
2. meningitis
3. spondylitis
4. arthritis
5. vegetative endocarditis

Front 66

how do you test for Brucellosis in humans?

Back 66

- blood culture
- serology (cross-reacts with Yersinia enterocolitica)

Front 67

how is brucellosis treated in humans?

Back 67

- tetracycline, TMS, or doxycycline and rifampin
- 6 weeks (intracellular organism)

Front 68

what are four ways to prevent brucellosis in people?

Back 68

1. pasteurize milk
2. wear obstetrics attire
3. gloves for vaccine administration
4. test and slaughter animals

Front 69

what causes pseudotuberculosis in humans?

Back 69

Yersinia pseudotuberculosis

Front 70

how is Yersinia pseudotuberculosis acquired in humans?

Back 70

- contact with infected animals
- ingestion of food contaminated with feces and/or urine from infected animals

Front 71

what are the zoonotic carriers of Yersinia pseudotuberculosis?

Back 71

- fowl and rodents: reservoir hosts
- lagomorphs and fowl: amplifying hosts
- cats and dogs may be infected from eating rodents and infected feed

Front 72

what are symptoms of pseudotuberculosis in people? (3)

Back 72

- acute mesenteric lymphadenopathy
- appendicitis
- inflamed ileocecal nodes

Front 73

which people are at most risk of acquiring Yersinia pseudotuberculosis

Back 73

males between 5-20 years old

Front 74

what are clinical signs of Yersinia pseudotuberculosis in cats? (5)

Back 74

1. anorexia
2. gastroenteritis
3. jaundice
4. palpable mesenteric lymph nodes
5. hepatosplenomegaly

Front 75

what are clinical signs of Yersinia pseudotuberculosis in Guinea pigs?

Back 75

1. enlarged mesenteric lymph nodes
2. nodular abscesses in intestinal wall, spleen, and liver
3. rapid weight loss and diarrhea

Front 76

how do you control Yersinia paratuberculosis? (2)

Back 76

- hygiene
- cook meat properly

Front 77

which zoonotic bacteria produces a toxin similar to that of E. coli heat stable toxin?

Back 77

Yersinia enterocolitica

Front 78

how is a person infected with Yersinia enterocolitica?

Back 78

ingestion of organism

Front 79

which animals are thought to be associated with zoonotic transmission of Yersinia enterocolitica?

Back 79

pigs, puppies, and kittens

Front 80

who is most susceptible to Yersinia enterocolitica

Back 80

kids and very old people

Front 81

what are symptoms of Yersinia enterocolitica in humans? (3)

Back 81

1. appendicitis-like symptoms
2. diarrhea
3. tummy ache

Front 82

what is the major way to prevent zoonotic transmission of Yersinia enterocolitica

Back 82

safe handling and proper cooking of pork

Front 83

what are 7 CDC recommendations for preventing salmonella transmission from reptiles to humans?

Back 83

1. provide info to owners and potential owners about risk
2. wash hands after handling reptiles
3. persons at risk (children < 5 and immunocompromised) should avoid contact
4. no reptiles in households with kids < 5 years and get rid of the reptile before mama-to-be pops
5. no reptiles in child care centers (DUH!)
6. don't let reptile roam free in house
7. keep reptile our of kitchen, food prep area; don't wash their equipment in these areas and if done in bath tub, disinfect the bathtub with bleach

Front 84

what is a weird bacteria, similar to salmonella, that kids can get from reptiles, and uncooked eggs and turkey?

Back 84

Arizona hinshawii

Front 85

what is the morphology of Campylobacter jejuni?

Back 85

- S-shaped bacteria (seagull wings)
- motile, gram-negative rods

Front 86

what are three symptoms of Campylobacter jejuni food poisoning in people (as well as other mammals)? How long does the disease take to run its course?

Back 86

1. gastroenteritis
2. diarrhea ± blood
3. abdominal pain
- recover in 7-10 days

Front 87

what antibiotic is used to treat Campylobacter infection?

Back 87

erythromycin

Front 88

what are three ways to control Campylobacter zoonotic infection?

Back 88

1. proper food preparation
2. avoid fecal-oral transmission (boy… tempting. How will I stop?)
3. general hygiene, you nasty disgusting person!

Front 89

Campylobacter fetus fetus (intestinalis)
- source other than food?
- symptoms in people? (2)

Back 89

- pregnant and aborting sheep and the birthing fluids
- abortion (miscarriage) in women; septicemia in immunocompromised people

Front 90

what are 4 names given to the disease caused by Yersinia pestis?

Back 90

1. Plague
2. Bubonic Plague
3. Black Death
4. Pest

Front 91

where in the US is plague most commonly found? (2)

Back 91

- the 4 corner states: NM, AZ, UT, CO
- state parks in California

Front 92

how is plague acquired?

Back 92

1. flea bites
2. exposure to the agent through abrasions in the skin or bites from infected animals
3. infected cats with draining abscesses and/or pneumonia

Front 93

why are fleas so efficient at transmitting plague?

Back 93

because Yersinia pestis multiplies in the proventriculus of the flea. When it feeds, it cannot swallow the blood, and instead regurgitates it back into its victim. The flea is still hungry, so it bites more people and animals

Front 94

what are the three syndromes of plague?

Back 94

1. Bubonic form - lymphadenopathy
2. septicemia - nervous and cerebral systems
3. pneumonic form - secondary to bubonic or septicemic, or primary if inhaled

Front 95

which type of plague has the highest mortality rate?

Back 95

pneumonic

Front 96

how do you control plague?

Back 96

1. insecticides
2. rodenticides - but depopulate slowly do fleas don't abandon rodents and go straight to humans
3. proper handling (PPE) of pneumonic cats and cats with lymphadenopathy

Front 97

what are four other names for tularemia?

Back 97

1. Deer Fly Fever
2. Rabbit Fever
3. Ohara's Disease
4. Francis' Disease

Front 98

what two agents are responsible for tularemia? Which is the most virulent?

Back 98

- Francisella tularensis types A and B
- type A is more virulent in humans and rabbits

Front 99

what are two bacterial bioterrorism agents that we have learned for this exam?

Back 99

1. Yersinia pestis
2. Francisella tularensis

Front 100

what are the main reservoir hosts for tularemia?

Back 100

1. wild rabbits
2. hares
3. beavers
4. muskrats
5. microtine mice
(and their Ixodes and Dermacentor ticks)

Front 101

what are three domestic animals that may transmit tularemia to humans?

Back 101

1. rabbits
2. sheep
3. cats

Front 102

how are people infected with Francisella tularensis? (5)

Back 102

1. skin via scratches or cuts
2. conjunctiva (e.g., nuzzling your infected rabbit)
3. oral: contaminated water or improperly cooked meat (especially rabbit meat)
4. dust or wool (sheep)
5. handling cats that have been in contact with diseased animals

Front 103

what are clinical signs of tularemia in cats? (3)

Back 103

1. malaise
2. oral ulcers
3. lymphadenopathy

Front 104

what are the four syndromes of tularemia in humans? Which is most fatal?

Back 104

1. ulceroglandular form - necrotic ulceration and local lymphadenopathy
2. oculoglandular form - ulcerated conjunctiva
3. pneumonic form - most fatal
4. typhoid form - gastroenteritis

Front 105

what are 3 clinical signs of tularemia in rabbits?

Back 105

1. swollen lymph nodes
2. splenic abscesses
3. liver necrosis and abscesses

Front 106

what two antibiotics are used to treat tularemia?

Back 106

streptomycin or gentamycin (aminoglycosides)

Front 107

what are four ways to prevent tularemia in people?

Back 107

1. necropsy or dress animals with gloves
2. properly cook game
3. disinfect water
4. insect repellant (i.e., to repel ticks that bite reservoir hosts)

Front 108

what are three other names for leptospirosis?

Back 108

1. Weil's disease
2. Swine herder's disease
3. Stuttgart disease

Front 109

why are we seeing a resurgence of leptospirosis in urban areas?

Back 109

Resurgence in urban areas because of raccoons. People feed their cats outside and raccoons contaminate

Front 110

what are the three most common serovars of Leptospira interrogans that infect dogs, what are two older ones that have been reduced by vaccination?

Back 110

- current: pomona, grippotyphosa, bratislava
- older: canicola and icterohemorrhagica

Front 111

what are five Leptospira interrogans serovars that infect humans?

Back 111

1. pomona
2. hardjo
3. icterohemorrhagica
4. canicola
5. grippotyphosa

Front 112

Leptospira
- what environment does it prefer?
- what is required for it to reproduce?

Back 112

- high humidity, neutral or slightly basic soil, warm temperatures
- must be in host to reproduce

Front 113

how do people acquire leptospirosis?

Back 113

through contact with:
- infected urine or materials contaminated with infected urine (e.g. ponds)
- milk
- placental material and fetuses

Front 114

how does Leptospira get into the body? (3)

Back 114

1. penetration of mucous membranes
2. abrasions in the skin
3. skin softened by prolonged immersion in water

Front 115

what are thought to be the highly persistent shedders of Leptospira?

Back 115

rodents

Front 116

besides dogs and rodents, what other animals carry Leptospira? (8)

Back 116

- deer
- opossum
- raccoons
- skunks
- foxes
- rabbits
- swine
- cattle

Front 117

what are the two basic syndromes of leptospirosis in humans?

Back 117

1. Anicteric form
2. Icteric form

Front 118

describe the symptoms of the anicteric form of leptospirosis in humans

Back 118

- fever, chills, malaise, myalgia, stiff neck, vomiting
- i.e., flu-like symptoms

Front 119

describe the symptoms of the icteric form of leptospirosis in humans

Back 119

septic meningitis with jaundice, petechia of the skin, renal insufficiency, and hepatomegaly

Front 120

what are three diagnostic tests for leptospirosis?

Back 120

1. microscopic agglutination test
2. blood culture first week
3. urine culture after first week

Front 121

how is leptospirosis vertically transmitted in humans?

Back 121

from mother's milk to child

Front 122

how do you control leptospirosis? (4)

Back 122

- proper clothing and personal hygiene
- rodent control
- environmental control
- vaccination of animals

Front 123

what causes psittacosis/ornithosis in humans?

Back 123

Chlamydiophila psittaci

Front 124

what is the source of Chlamydiophila psittaci?

Back 124

parrots, parakeets (aka budgies), love birds, pigeons; also occupational with turkeys

Front 125

what are symptoms of psittacosis in humans?

Back 125

respiratory illness, cough, chest pain, pharyngitis, pleurisy (pleuritis), pneumonia

Front 126

what are the clinical signs of Chlamydiophila psittaci in birds?

Back 126

- mainly GI signs
- occasionally conjunctivitis, pneumonitis

Front 127

which antibiotics are used to treat psittacosis in humans?

Back 127

tetracyclines, doxycycline

Front 128

what are four ways to prevent psittacosis in humans?

Back 128

1. avoid aerosolizing bird droplets (e.g., wet droppings before cleaning)
2. quarantine and treatment of birds
3. 0.5% chlortetracycline in birds' feed for 45 days
4. test birds with an elementary body agglutination test (IgM)

Front 129

chlamydiosis in sheep:
- causative agent?
- how do people get infected?
- symptoms in humans?

Back 129

- Chlamydiophila abortus
- fetal and uterine fluids of infected ewes
- abortions in humans

Front 130

chlamydiosis in cats
- causative agent?
- symptoms in humans?

Back 130

- Chlamydiophila felis
- not zoonotic

Front 131

what causes Q fever?

Back 131

Coxiella burnetii

Front 132

what are the sources of Coxiella burnetii (Q fever) infection in humans? (8)

Back 132

- uterine discharges
- urine
- feces
- milk
- wool in slaughterhouses
- zoo animals
- air conditioner ducts in common with animal quarters
- queening cats and kindling rabbits, from uterine discharges

Front 133

what are symptoms of Q fever in humans?

Back 133

- most common: fever, chills, sweating, malaise, and sinus headache
- less common: dry cough, nausea, vomiting, diarrhea, pneumonitis, endocarditis, and splenomegaly
- many cases go unnoticed because of mild condition
- no rash

Front 134

what is the most tell-tale sign that Q fever may be on the farm?

Back 134

sheep and goats are aborting

Front 135

what is the causative agent of Lyme disease?

Back 135

Borrelia burgdorferi

Front 136

what are the reservoir hosts of Lyme disease?

Back 136

- white-footed mouse, deer mouse, chipmunks, house mouse, Norway rat, rabbits
- Lizards?
- birds carry but don't transfer organism to humans effectively

Front 137

how is a person infected with Lyme disease?

Back 137

Ixodes tick bites; takes 48 hours for transfer of organism

Front 138

what is the medical name of the target rash associated with Lyme disease?

Back 138

erythema chronicum migrans

Front 139

what are clinical signs of Lyme disease in dogs?

Back 139

1. arthritis that responds to antibiotic treatment
2. shifting leg lameness
3. fever
4. anorexia
5. lymphadenopathy
6. renal disease

Front 140

how long after a tick bite do humans get Lyme disease?

Back 140

3 days - 1 month

Front 141

what is the tell-tale sign of Lyme disease in humans?

Back 141

erythema chronicum migrans: painless, non-pruritic rash that looks like a "target"

Front 142

what are the typical initial symptoms of Lyme disease in humans?

Back 142

1. malaise
2. fever
3. fatigue
4. arthralgia
5. myalgia
6. cephalgia (headache)

Front 143

what are some chronic symptoms of Lyme disease in humans?

Back 143

1. meningitis, encephalitis, facial paralysis
2. AV block and tachycardia
3. polyarthritis

Front 144

how is Lyme disease treated in humans?

Back 144

- full-blown disease: doxycycline (in children, amoxicillin) for 10-30 days
- if caught early: oral antibiotics such as tetracycline or penicillin

Front 145

what are 6 ways to prevent Lyme disease in humans?

Back 145

1. avoid tick infested areas (thick grass/vegetation)
2. mow your lawn
3. wear light colored clothing so you can see ticks and remove them
4. tuck pant legs into boots and wear long-sleeved shirts, buttoned at the wrists
5. tick checks q 4-6 hours
6. DEET on skin; permethrin on clothing

Front 146

what is the genetics of methicillin resistance in MRSA?

Back 146

a mutated mecA gene, which encodes an altered penicillin-binding protein; does not allow binding of β-lactams

Front 147

what are the two most common types of MRSA in humans?

Back 147

1. community-associated MRSA
2. nosocomial- or hospital-associated MRSA

Front 148

community-associated MRSA
- who gets it?
- symptoms
- risk factors

Back 148

- otherwise healthy people without recent hospitalization or anything like that
- skin and soft tissue infection
- crowding, frequent contact, compromised skin, contaminated surfaces (the gym), shared items, poor hygiene

Front 149

nosocomial- or hospital-associated MRSA
- who gets it?
- risk factors

Back 149

- immunocompromised individuals in hospitals and healthcare centers
- risk factors: hospitalization, surgery, dialysis, long-term care, indwelling devices, previous Hx of MRSA

Front 150

what type of MRSA is thought to be a major factor in the rise of MRSA infection in companion animals?

Back 150

community-associated MRSA

Front 151

name the bacterial strain for:
- CA-MRSA
- HA-MRSA
- MRSA in large animals
- predominant strain in small animals

Back 151

- CA-MRSA: USA300
- HA-MRSA: USA100
- large animals: USA500
- small animals: USA100 (also nasal passages in horses)

Front 152

which antibiotic is used to treat MRSA in humans?

Back 152

vancomycin

Front 153

what are 5 precautions that owners treating a pet infected with MRSA should take?

Back 153

1. wear disposable gloves when changing bandages and treating open wounds
2. disinfect contaminated hard surfaces
3. avoid touching nose, face, eyes when caring for or cleaning up after infected animal
4. wash hands frequently with soapy water or use hand sanitizer
5. wash animal bedding in hot water, use laundry detergent, and dry hot

Front 154

how do fiber and grain affect milk fat content?

Back 154

- higher fiber diets have higher fat content
- high grain diets suppress fat content

Front 155

what is the fat content of
- whole milk?
- 2% milk?
- skim milk?

Back 155

- whole: 3.5%
- 2%: 2%
- skim: 0.1%

Front 156

what are the three major constituents of milk?

Back 156

1. water
2. butter fat
3. solids non-fat (SNF)

Front 157

what percent of milk is SNF?

Back 157

8-9%

Front 158

what is used to make sure water has not been added to milk?

Back 158

cryoscope

Front 159

what is transitional milk?

Back 159

milk in between colostrum and milk; discarded for 5-6 milkings

Front 160

what are 5 requirements for USDA Grade A milk?

Back 160

1. no objectionable odors
2. bacterial count < 100,000 cells/mL
3. no drug residues
4. somatic cell count < 750,000 cells/mL
5. bulk tank temp of 40 °C or less within 2 hours of milking and remain at or below this temperature during storage

Front 161

why is transitional milk discarded?

Back 161

it contains residues of antibiotic therapy

Front 162

what is the technique called to measure bacteria quantity in milk to attain Grade A status?

Back 162

standard plate count

Front 163

what are common sources of feed and weed flavors in milk?

Back 163

- wild onion or garlic
- strong flavored feedstuffs such as alfalfa silage

Front 164

what causes "cow-barny" flavors in milk?

Back 164

when milk is obtained from unclean or poorly ventilated environments and/or improperly sanitized milk equipment

Front 165

what causes rancid flavors in milk?

Back 165

- presence of free fatty acids from
- excessive agitation of milk during collection or transport
- breakdown of milk fat component by proteolytic and lipolytic enzymes present in raw milk

Front 166

what are the two basic laboratory tests performed to assess milk quality?

Back 166

1. Standard Plate Count test (SPC)
2. Preliminary Incubation count (PI)

Front 167

Standard Plate Count test for milk:
- how often is it performed?
- incubation conditions
- tolerance levels

Back 167

- monthly
- incubated at 32 °C (about 90 °F) for 48 hours
- 100,000 bacteria/mL is the legal maximum; most farms are under 10,000

Front 168

Preliminary Incubation (PI) count for milk:
- what does this test tell you about the milk?
- incubation conditions
- tolerance levels

Back 168

- information about shelf life and correlate with the sanitary conditions on farms
- 55 °F for 18 hours
- 100,000 bacteria/mL is acceptable; goal is 20,000 or less

Front 169

what type of bacteria in milk survive pasteurization? What are two genera?

Back 169

- thermoduric bacteria
- Lactobacilli and Enterococci

Front 170

what type of bacteria are most responsible for producing the off-flavors in milk?

Back 170

psychrotrophic bacteria

Front 171

if psychrotrophic bacteria are killed during pasteurization, why is it still important to keep their levels in milk low?

Back 171

because their lipolytic and proteolytic enzymes survive pasteurization

Front 172

psychrotrophic bacteria:
- percent of total microflora in sanitary conditions
- percent of total microflora in unsanitary conditions
- how are they detected in analysis?

Back 172

- 10% in good sanitation
- > 75% in poor sanitation
- detected in the PI count

Front 173

what are two spore-forming bacteria that survive milk pasteurization?

Back 173

Clostridium and Bacillus

Front 174

what are four basic ways to control the amount of bacteria in milk at the farm level?

Back 174

1. cow cleanliness
2. clean milking practices
3. cleaning of milking equipment and storage tanks
4. proper storage conditions in the bulk tank

Front 175

what are two ways to improve cow cleanliness to keep milk bacterial counts low?

Back 175

1. cow housing: design and maintenance
2. clip or singe the hair off the cow's udder and switch (once per year by law)

Front 176

what are four milking practices that can keep milk bacterial counts low?

Back 176

1. wash and disinfect teats (but not udders) before each milking
2. use disinfectants in wash water
3. dry with individual towels
4. avoid common wash buckets, rags

Front 177

what are 5 things you can do in the cleaning of milk equipment and bulk tanks to keep milk bacterial counts low?

Back 177

1. hand washing, automatic washing, or a combination
2. hot water
3. alkaline or chlorinated cleaners for organic soils
4. acidified rinses for mineral (thermoduric bacteria live in milk stone)
5. pre-milking sanitizing to kill organisms not killed in the cleaning process

Front 178

what type of bacteria are associated with:
- hair on the cow?
- high bulk tank temperature?
- milk stone?
- improper cleaning of equipment?

Back 178

- hair: all types, including psychrotrophs
- bulk tank: coliforms
- milk stone: thermoduric bacteria
- improper cleaning of equipment: all types, including psychrotrophs (high PI counts)

Front 179

what are four specifications of a good bulk milk tank?

Back 179

1. cools to 40 °F within 2 hours of milking; tank must be able to cool 1/4 capacity from 90 °F to 40 °F in 2 hours and then hold below 40 °F
2. 24-hour temperature recording
3. dual compressors
4. in-line heat exchangers

Front 180

typically, what fraction of bacteria in milk is killed during the pasteurization process?

Back 180

85-95%

Front 181

how were the temperatures and times of pasteurization determined?

Back 181

set to kill Coxiella burnetii (Q fever)

Front 182

how can you tell if milk has been pasteurized or not?

Back 182

pasteurization denatures alkaline phosphatase. If AP activity is positive, inadequate pasteurization

Front 183

pasteurization time and temp for milk:
- traditional method
- high-temperature, short time method
- UHT method

Back 183

- traditional: 145 °F for 30 minutes
- HTST: 161 °F for 15 seconds
- UHT: 280 °F for 2 seconds

Front 184

pasteurization time and temp for cream:
- traditional method
- high-temperature, short time method

Back 184

- traditional: 150 °F for 30 minutes
- HTST: 166 °F for 15 seconds

Front 185

pasteurization time and temp for ice cream and eggnog:
- traditional method
- high-temperature, short time method

Back 185

- traditional: 155 °F for 30 minutes
- HTST: 175 °F for 25 seconds

Front 186

in milk, what somatic cell count indicates
- no infection?
- possible infection?
- probable infection?

Back 186

- no infection: ≤ 150,000
- possible infection: 150,000 - 500,000
- probable infection: ≥ 500,000

Front 187

when do legal tolerance limits of somatic cell count in milk apply?

Back 187

interstate commerce

Front 188

what are somatic cell count tolerance levels set by
- the USDA?
- fancy European countries?

Back 188

- USDA: < 750,000 /mL
- fancy European countries: < 400,000 /mL

Front 189

what is the name of the 1960 law passed by Congress that provided for "zero tolerance" for foreign substances in human foods?

Back 189

Delaney Clause

Front 190

what is the biggest residue concern in milk?

Back 190

antibiotics

Front 191

what is the most commonly tested-for residue in milk?

Back 191

β-lactams

Front 192

what type of tests are most antibiotic residue tests?

Back 192

they are based on inhibition of bacterial growth

Front 193

what drug has been routinely tested for in milk since 2011?

Back 193

Banamine (flunixin)

Front 194

what is used to detect foreign materials (e.g., rat droppings, maggots) in milk?

Back 194

sedimentation test

Front 195

describe the course of milk from the teat end to the cup

Back 195

1. teat end
2. inflation
3. bowl
4. long milk tube
5. milk line
6. receiver jar
7. milk sock
8. bulk tank
9. milk hose
10. milk truck
11. milk silo
12. processing equipment
13. product truck
14. store
15. home refrigerator
16. cup

Front 196

name 7 zoonotic bacteria that can be found in raw milk.

Back 196

1. Brucella
2. Campylobacter
3. Coxiella
4. E. coli O157:H7
5. Listeria
6. Salmonella
7. Tuberculosis

Front 197

what are symptoms associated with food-borne salmonellosis?

Back 197

- incubation of 8-72 hours
- fever, malaise, abrupt onset of nausea, abdominal pain, diarrhea, vomiting
- generally a self-limiting disease
- may not feel normal for 2-3 weeks after diarrheal episode
- has been associated with reactive arthritis

Front 198

how is food-borne salmonellosis diagnosed?

Back 198

culture and serotyping

Front 199

how can you detect salmonella in your food?

Back 199

you can't

Front 200

epidemiology of salmonellosis:
- routes of transmission
- what type of food is it most commonly found in?

Back 200

- fecal-oral: direct and indirect (e.g., on food)
- ground beef (7.5% prevalence)

Front 201

what are 5 ways that Salmonella is transmitted to food?

Back 201

1. contaminated during processing
2. contaminated raw food that receives no further treatment (e.g. beef tartar)
3. workers with poor personal hygiene (e.g., don't wipe their asses)
4. contamination of properly cooked food from unclean equipment, counter-tops, etc.
5. eggs: transovarially or checked eggs

Front 202

what are 5 ways to prevent food-borne salmonellosis?

Back 202

1. hygienic slaughter, processing and handling of meat
2. pasteurization of milk and eggs
3. proper cooking of prepared foods
4. prevent cross-contamination
5. personal hygiene (you nasty, nasty gross person)

Front 203

proper cooking of food to prevent salmonellosis:
- fried eggs
- boiled eggs
- meat (e.g. ground beef)

Back 203

- fry eggs until yolks are solid
- boil eggs for at least 9 minutes
- meat should be cooked to 165 °F and juices run clear

Front 204

what is the etiologic agent for Staphylococcal food poisoning?

Back 204

Staphylococcus aureus - toxins A-E

Front 205

Staphylococcus aureus food poisoning
- what type of toxin?
- how much toxin to make you sick?
- what concentration of bacteria is necessary to produce this level of toxin?

Back 205

- a heat-stabile enterotoxin
- < 1 μg can make you sick
- ≥ 100,000 bacteria/gram of food to reach this level

Front 206

what are the two most common reservoirs for Staphylococcus aureus that causes food poisoning?

Back 206

1. humans (skin and respiratory tract)
2. cow mammary glands

Front 207

what is the incubation period for Staphylococcus aureus food poisoning?

Back 207

30 minutes - 8 hours (usually 2-4 hours)

Front 208

what are symptoms of Staphylococcal food poisoning?

Back 208

- nausea, vomiting, diarrhea, intestinal cramps
- severe cases: headache, fever, hypotension, and blood in vomitus and stools
- recovery within 24 hours

Front 209

what is the recovery time for Salmonella food poisoning?

Back 209

may not feel normal for 2-3 weeks after diarrhea

Front 210

what is the recovery time for Staphylococcus aureus food poisoning?

Back 210

24 hours

Front 211

how is Staphylococcal food poisoning diagnosed?

Back 211

culture and/or demonstration of enterotoxin in food by serological or biological tests. Only toxin needs to be present

Front 212

what foods are commonly associated with Staphylococcus aureus food poisoning outbreaks? (5)

Back 212

- high-salt content ham
- processed poultry products
- cured meats
- salads (e.g., potato salad with mayo, mixed with hands)
- cream filled pastries
- raw milk/cheese

Front 213

how to you detect Staphylococcus in your food

Back 213

you can't

Front 214

how do you control Staphylococcus aureus outbreaks in food?

Back 214

- high or low temperature storage
- educate food handlers that their hands are disgusting, germ-ridden, cesspools of disease

Front 215

which agent causes Clostridium perfringens food poisoning in people?

Back 215

C. perfringens type A-toxin

Front 216

where is Clostridium perfringens type A toxin, which causes food poisoning, formed by the bacteria?

Back 216

in the food and the host

Front 217

what are the reservoirs for Clostridium perfringens type A, which causes food poisoning in people?

Back 217

soil, water, and intestinal tracts of people and animals

Front 218

what is the incubation period for Clostridium perfringens food poisoning?

Back 218

8-24 hours

Front 219

what is the recovery time for Clostridium perfringens food poisoning?

Back 219

8-24 hours

Front 220

what are the symptoms of Clostridium perfringens type A food poisoning?

Back 220

watery diarrhea, intestinal gas, cramps, and nausea (usually no vomiting or fever)

Front 221

how is Clostridium perfringens food poisoning diagnosed?

Back 221

culture organism

Front 222

epidemiology of Clostridium perfringens type A food poisoning:
- where does it grow
- when does it produce toxin?
- what types of food is it associated with?

Back 222

- grows in anaerobic environments in the environment, intestinal tract, and cooked food
- produced toxin when it sporulates
- improper storage of food, left-overs that had not been cooled down properly, reheated food allowed to sit before eating; common at banquets and holiday meals, where food is prepared and it sits awhile

Front 223

how do you inactivate Clostridium perfringens type A enterotoxin and spores?

Back 223

boil for 3 minutes

Front 224

how do you detect Clostridium perfringens in your food?

Back 224

you can't

Front 225

how do you control Clostridium perfringens outbreaks in food?

Back 225

- adequate heating to inactivate spores and toxin
- eat food hot
- refrigerate leftovers quickly
- separate broth/gravy from meat to prevent anaerobic environment

Front 226

what causes botulism in humans?

Back 226

Clostridium botulinum types A - G toxins

Front 227

where are Clostridium botulinum toxins formed

Back 227

in food or host

Front 228

what serovars (types) of Clostridium botulinum are found in
- humans?
- improperly canned foods?
- mammals other than humans?
- fowl?
- smoked fish?

Back 228

- humans: A, B, E, F
- improperly canned foods: A, B
- mammals other than humans: C, D
- fowl: A, C
- smoked fish: G

Front 229

what are reservoirs for Clostridium botulinum?

Back 229

soil, water, intestinal tracts of people, animals, and fish

Front 230

what is the incubation period for botulism?

Back 230

2 hours - 8 days (usually 1-2 days) after consumption

Front 231

what is the recovery time for botulism?

Back 231

may take 6-8 months

Front 232

what are symptoms of botulism in adult humans?

Back 232

- nausea, vomiting, and abdominal pain, followed by impaired vision
- difficulty swallowing and in speech, muscular weakness and paralysis

Front 233

what are symptoms of botulism in infant humans?

Back 233

constipation → weakness → poor feeding → loss of head control

Front 234

what is an infamous source of botulism in babies?

Back 234

honey

Front 235

how is botulism diagnosed?

Back 235

ID of toxin in serum or stools

Front 236

what are three causes of botulism?

Back 236

1. improper canning
2. improper food storage
3. honey

Front 237

preventing botulism:
- time and temp to kill spores when canning
- time and temp to cook food to destroy toxin

Back 237

- canning: ≥ 250 °F for 20 minutes
- cook at 176 °F for 30 minutes or boil for 10 minutes to destroy toxin

Front 238

what is the most common cause of enteritis in humans?

Back 238

Campylobacter jejuni

Front 239

what are reservoirs for Campylobacter jejuni, which can contaminate food?

Back 239

cattle, poultry, shellfish, produce

Front 240

what is the incubation period for Campylobacter jejuni food poisoning?

Back 240

2-5 days

Front 241

what are symptoms of Campylobacter jejuni food poisoning?

Back 241

- diarrhea, abdominal cramps, headache, and fever
- associated with Hemolytic Uremic Syndrome and Guillain Barré Syndrome

Front 242

what age groups of people are predisposed to Campylobacter jejuni food poisoning?

Back 242

- children < 5
- 15-29 year olds

Front 243

how is Campylobacter jejuni food poisoning diagnosed?

Back 243

culture

Front 244

why is it relevant for food safety that the infectious dose of Campylobacter jejuni is about 500 cells (low dose)?

Back 244

because cross-contamination is a problem

Front 245

what are the two major sources of Campylobacter jejuni in food?

Back 245

- raw dairy
- POULTRY (up to 80% of carcasses are infected)

Front 246

what are 3 ways to control Campylobacter jejuni food-borne outbreaks?

Back 246

1. cleanliness in milk handling and slaughter of poultry
2. proper cooking and pasteurization
3. prevent cross-contamination of food (e.g., don’t prepare the salad on the cutting board where you just had the raw chicken)

Front 247

what is the major reservoir for E. coli O157:H7?

Back 247

cattle

Front 248

what are the clinical signs of E. coli O157:H7 in cattle?

Back 248

- older cattle are asymptomatic
- calves 1-4 months may have bloody diarrhea

Front 249

what is the incubation period for E. coli O157:H7 food poisoning?

Back 249

48 hours

Front 250

what are symptoms of E. coli O157:H7 food poisoning?

Back 250

- enteritis, blood in feces
- ± hemolytic uremic syndrome
- most common cause of acute renal failure in children

Front 251

why is E. coli O157:H7 very dangerous to children?

Back 251

it can cause acute renal failure

Front 252

how is E. coli O157:H7 food poisoning diagnosed?

Back 252

culture of stool, food product

Front 253

where in the US is E. coli O157:H7 most prevalent?

Back 253

Northwest

Front 254

what is the infectious dose of E. coli O157:H7?

Back 254

as low as 10 organisms

Front 255

in what foods has E. coli O157:H7 been found?

Back 255

- milk
- meat (especially ground beef)
- vegetables (e.g., spinach)
- alfalfa sprouts
- unpasteurized apple cider

Front 256

what are venues where E. coli O157:H7 can be transmitted to humans?

Back 256

1. fecal contamination of food
2. person-to person (e.g. day care facilities)
3. petting zoos and fairs
4. rafters of barns

Front 257

what are 5 ways to control E. coli O157:H7

Back 257

1. pasteurize
2. cook meat to 160 °F and until juices run clear
3. wash vegetables
4. wash hands after handling or being exposed to animals
5. don't eat in areas where animals are being housed or exhibited

Front 258

what is the toxin produced by EHEC (enterohemorrhagic E. coli) that brings on the hurt?

Back 258

Shigella toxin type 1 or 2

Front 259

how is EHEC food poisoning diagnosed?

Back 259

culture of stool, food product

Front 260

what are four foods in which EHEC food poisoning outbreaks have been found?

Back 260

1. Romaine lettuce
2. ground beef
3. bear jerky
4. sprouts (in Europe)

Front 261

if EHEC is found in beef during routine inspection at a meat processing plant, what is done with the meat?

Back 261

- can't be sold raw to the public
- it is either destroyed, or is heavily cooked for things like chili, stews, etc.

Front 262

in what foods can you find Listeria monocytogenes?

Back 262

milk, vegetables, poultry, processed meats (e.g. hot dogs, lunch meats)

Front 263

who is most at risk of food poisoning from Listeria? (5)

Back 263

- children
- immunocompromised individuals
- pregnant women
- people on antacids
- people older than 60

Front 264

what is the incubation period for Listeriosis?

Back 264

3-47 days

Front 265

what are symptoms of Listeriosis in people?

Back 265

- chills, fever, headache
- septicemia
- abortion (miscarriage) in pregnant women

Front 266

which food-borne bacteria is a psychrophile?

Back 266

Listeria monocytogenes

Front 267

how do you control Listeria in food?

Back 267

pasteurization and proper cooking

Front 268

what food is associated with Vibrio parahaemolyticus?

Back 268

shellfish

Front 269

what is the incubation period for Vibrio parahaemolyticus?

Back 269

4 hours - 4 days

Front 270

what are symptoms of Vibrio parahaemolyticus food poisoning from shellfish?

Back 270

after 4 hours - 4 days, acute gastroenteritis, vomiting, fever, diarrhea. Lasts for 3 days.

Front 271

what is the recovery time for Vibrio parahaemolyticus?

Back 271

3 days

Front 272

how do you diagnose a Vibrio parahaemolyticus food poisoning from shellfish?

Back 272

culture seafood

Front 273

under what conditions are shellfish likely to be contaminated by Vibrio parahaemolyticus?

Back 273

- uncooked/improperly cooked and/or refrigerated shellfish
- if they have been harvested in warm waters (e.g. Gulf of Mexico in months that do not have the letter "R" in their name)

Front 274

how do you detect Vibrio parahaemolyticus in shellfish?

Back 274

you can't

Front 275

how do you detect Clostridium botulinum in your food?

Back 275

bulging cans, gassy contents, malodorous and obviously spoiled

Front 276

which bacteria causes food poisoning in shellfish, contact with the marine environment (e.g. drinking pond water), and raw fish?

Back 276

Vibrio vulnificus

Front 277

what are symptoms of food poisoning from fish or shellfish caused by Vibrio vulnificus?

Back 277

fever, chills, nausea, vomiting, abdominal pain

Front 278

who is at greatest risk of contracting Vibrio vulnificus food poisoning from shellfish or fish?

Back 278

- people with chronic illnesses such as liver disease
- immunocompromised

Front 279

if you have liver disease and eat raw oysters, what are you asking to get?

Back 279

Vibrio vulnificus septicemia, and if you get it, you have a 50% chance that you will die

Front 280

how is seafood poisoning from Vibriosis treated?

Back 280

tetracyclines

Front 281

what is scromboid toxicity?

Back 281

when proteus and/or Klebsiella act on fish muscle with high tryptophan content (tuna, bluefish, mackerel, Mahi-Mahi), they produce a histamine like substance, which causes misery.

Front 282

what are symptoms of scromboid toxicity?

Back 282

- histamine release type reaction
- nausea, vomiting, facial flushing, labial edema, oral burning sensation

Front 283

how do you prevent scromboid toxicity?

Back 283

proper refrigeration of fish so that proteus and Klebsiella don't start breaking down the meat

Front 284

what causes paralytic shellfish poisoning?

Back 284

caused by a dinoflagellate (Gymnodium breve) that causes red tide.

Front 285

what are four syndromes associated with paralytic shellfish poisoning?

Back 285

1. paralysis - after 30 minutes
2. erythema
3. GI - nausea, vomiting, diarrhea
4. respiratory - allergy type reaction

Front 286

Ciguatoxin:
- what produces it?
- in what foods do you find it?
- how is it inactivated in food

Back 286

- dinoflagellates
- fish high up in the food chain such as barracuda, grouper, red snapper
- cooking doesn't inactivate it.

Front 287

what are symptoms of ciguatoxin poisoning from eating contaminated barracuda, grouper, or red snapper?

Back 287

GI, followed by burning or prickling sensations, muscle aches, cramping, weakness, ataxia, and death from respiratory paralysis