Over the past 20 years, there has been a major change in the epidemiology of foodborne illness. Many factors have contributed to the change, including genetic factors, host susceptibility, new foodborne zoonoses, antimicrobial resistance, and a substantial increase in international travel and in globalization of food trade. In fact, international food trade increased 300% over the two decades and the dollar level reached over $400 billion in 1998. This has led to foodborne illness episodes and epidemics that are no longer confined to local or regional geographic areas. The recently emerged protozoan Cyclospora cayetanensis outbreaks in North America, which are thought to be associated with consumption of contaminated imported produce, illustrate this transnational challenge of illness spread through international food trade.

The purpose of this book is to serve as a reference—a problem-solving compendium for food microbiologists, public health professionals, prudent processors (especially those engaged in international trade), food scientists, and biological science students with an interest in food safety. Our intent is to provide current information from an international perspective on the identification and characterization of the microbes, geographic incidence, and the challenge of control and prevention. We hope that practitioners, researchers, and students will find this a useful resource for topics related to foodborne disease of microbial origin.

This handbook is divided into three major parts. Part I characterizes the microbes. The same general topic format is presented for each organism or group of organisms. (For some organisms, the format varies because of lack of knowledge or research in certain topics.) Academic, government, and industry professionals who are actively pursuing research on the microbes were chosen as the authors of these chapters. Besides the conventional microbial foodborne pathogens described in this handbook—viruses, bacteria (including emerging bacterial pathogens, such as Mycobacterium avium paratuberculosis and Enterobacter sakazakii), fungi, protozoa, helminths, and marine organisms—a new infective form, the prion, has recently been described. Prion proteins have been implicated in transmissible spongiform encephalopathies (TSE). Recently, a variant form of CreutzfeldtJakob Disease (CJD), the spongiform encephalopathy of humans, has been associated with consumption of beef from cows with mad cow disease (the bovine form of TSE, BSE). A cluster of CJD cases was recently reported in the United Kingdom during a widespread epizootic of BSE. Since many aspects of this syndrome are poorly understood, numerous opposing theories have been presented to explain this disease. One of the many objectives of this manual is to provide a better understanding of this complex syndrome.

Part II is a geographic summary, which calls on various public health officials to assess the incidence, epidemiology, and risk assessment of foodborne illness in their respective regions of the world. Part III describes microbial risk assessment, the hazard analysis and critical point (HACCP) approach to providing a safe food supply, and the role of international bodies such as ISO, CODEX Alimentarius, and OIE in attaining this goal.

We are indebted to all the authors for their immense efforts in preparing their informative and innovative chapters. We also greatly appreciate the efforts of Dr. Fritz Kaferstein for his guidance and assistance in this endeavor.

Marianne D. Miliotis Jeffrey W. Bier

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