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Appendix V - Common and Important Types of Food Poisoning in Hong Kong

Types of Food Poisoning
Causative Agent
Incubation / Onset Period
Symptoms
Source
Common Foods Involved
Prevention
Bacterial Food Poisoning Vibrio parahaemolyticus usually 12-24 hours, range 4-30 hours diarrhoea, abdominal pain, nausea, vomiting, fever marine environment, seafood, shellfish raw or undercooked seafood, shellfish, marine products and salted food (e.g. jellyfish, cuttlefish, salted vegetables and smoked knuckles, etc.)
  • proper storage temperature and duration of display
  • thoroughly cook seafood
  • avoid eating raw seafood
  • proper storage of cooked food to avoid cross-contamination
Salmonella spp. usually 12-36 hours,range 6-72 hours abdominal pain, diarrhoea, nausea, vomiting, fever domestic and wild animals, poultry, pigs, cattle, eggs raw or undercooked egg and egg products (e.g. Tiramisu); undercooked meat, poultry and their products (e.g. barbecued and preserved meat, goose intestines, etc.)
  • thorough cooking
  • avoid using unpasteurized eggs to make pastry and desserts
Staphylococcus aureus usually 2-4 hours, range 30 minutes to 8 hours nausea and vomiting (prominent), abdominal pain, diarrhoea human skin, hair, nasal cavity, throat, wounds foods which have been subject to a large amount of handling; with no subsequent cooking and reheating (e.g. lunch boxes, cakes, pastries, sandwiches, etc.)
  • strict compliance to good food, personal and environmental hygiene
  • proper storage condition and temperature
  • adequate and rapid cooling and reheating
Bacillus cereus 1-6 hours if vomiting is predominant; 6-24 hours if diarrhoea is predominant nausea and vomiting; or diarrhoea and abdominal pain an ubiquitous organism in soil and environment leftover cooked rice, fried rice, meat products and vegetables
  • refrigerate leftovers promptly
  • reheat thoroughly and rapidly
Clostridium perfringens usually 10-12 hours, range 6-24 hours diarrhoea, abdominal pain, nausea soil, gastro-intestinal tract of healthy people and animals inadequately cooked meat and meat products (e.g. stew and meat pies, etc.)
  • proper storage temperature
  • adequate and rapid cooling and reheating
Clostridium botulinum usually 12-36 hours for foodborne botulism blurred or double vision, dysphagia, dry mouth, paralysis; vomiting and constipation / diarrhoea soil, gastro-intestinal tract of animals canned food and meat products
  • proper processing and preparation of canned and preserved foods
  • avoid amateur production of such foods
Campylobacter spp. usually 2 to 5 days, range 1 to 10 days diarrhoea, abdominal pain, malaise, fever, nausea and vomiting animals, most frequently poultry and cattle undercooked chicken and pork, unpasteurised milk
  • thorough cooking
  • use pasteurized milk
Listeria monocytogenes 3 to 70 days, median 3 weeks meningoencephalitis and / or septicaemia, particularly in newborn, elderly and immunocompromised people; fever and abortion in pregnant women soil, forage, water, mud and silage; infected domestic and wild mammals, fowl and people; asymptomatic carrier in human raw or contaminated milk, soft cheese, vegetables and ready-to-eat meat, salad, cold food side dish
  • pregnant women and immunocompromised individuals should avoid soft cheese and deli meat;
  • use only properly cooked meat and pasteurized dairy products
Viral Food Poisoning Norwalk-like viruses(Norovirus) usually 24-48 hours, range 10-50 hours nausea, vomiting, diarrhoea, abdominal pain, fever contaminated water or shellfish, particularly filter feeders such as oysters and clams raw or inadequately cooked shellfish
  • proper storage temperature and duration of display,
  • thoroughly cook shellfish
  • avoid eating raw shellfish
  • proper storage of cooked food to avoid cross-contamination
Chemical Food Poisoning Clenbuterol 30 minutes to 6 hours tachycardia, tremor, hypertension, and muscle-relaxing effects veterinary drug contaminated pig's offal or pork
  • purchase pig's offal or pork from approved / licensed and reputable suppliers
Pesticide Poisoning Organophosphorus e.g. Methamidophos up to 12 hours, usually within 6 hours; onset is often fast mild exposure : headache, fatigue, dizziness, loss of appetite with nausea, stomach cramps and diarrhoea, blurred vision associated with excessive tearing, rippling of surface muscles just under the skin.
severe poisoning: incontinence, unconsciousness and seizures		 vegetables and fruits contaminated by agricultural pesticides agricultural commodities such as leafy vegetables and fruits
  • buy vegetables and fruits from reputable shops
  • wash and immerse vegetables and fruits in clean water for 1 hour
Carbamates
Organochlorine can occur soon after exposure nausea and vomiting, apprehension, excitability, dizziness, headache, disorientation, weakness, a tingling or pricking sensation on the skin and muscle twitching
Pyrethroids (synthetic) onset is often fast (the main effects of Pyrethroids have been shown to be reversible) skin irritation like stinging, burning; very large doses may rarely cause muscle incoordination, tremors, salivation, vomiting, diarrhoea and irritability to sound and touch
Paralytic Shellfish Poisoning(most common shellfish poisoning) Toxic Algae -Dinoflagellates: Alexandrium spp., Gymnodinium catenatum, Pyrodinium bahamense that produce saxitoxin, neosaxitin onset of symptoms is rapid; there are some severe cases that may result in respiratory arrest within 24 hours of consumption of the toxic shellfish tingling, numbness, and burning of the perioral region, ataxia, fever, rash and staggering shellfish contaminated with phycotoxins that are produced by free-living micro-algae, upon which the shellfish feed bivalve shellfish such as oysters, clams, mussels, fan shells, scallops, etc. are common vehicles responsible for shellfish poisoning
  • buy shellfish from reputable and licensed seafood shops
  • eat a smaller amount of shellfish in one meal
  • avoid eating the viscera, gonad and roe
Diarrheic Shellfish Poisoning Toxic Algae -Dinoflagellates: Dinophysis spp., and Prorocentrum lima that produce okadaic acid and dinophysistoxin-1 symptoms usually begin within 30 minutes to a few hours after consuming contaminated shellfish diarrhoea, nausea, vomiting, chills, and moderate to severe abdominal pain and cramps
Neurotoxic Shellfish Poisoning Toxic Algae -Dinoflagellates: Gymnodinium breve that produces brevetoxins after 3 to 6 hours, symptoms tend to be mild and may resolve quickly tingling of facial muscles, cold and hot sensory reversal, bradycardia and dilation of pupils
Amnesic Shellfish Poisoning Marine diatoms :Nitzschia (or Pseudonitzschia) -P. pungens,P. australis and P. pseudodelicatissima that produce domoic acid 15 minutes to 38 hours vomiting, abdominal cramps, diarrhoea, headache and in particular a short-term memory loss
Ciguatera Fish Poisoning Toxic Algae -Dinoflagellates: possible Gambierdiscus toxicus produces ciguatoxin several hours after consuming toxic fish vomiting, diarrhoea, numbness of extremities, mouth and lips, reversal of hot and cold sensation, as well as muscle and joint aches fish containing ciguatoxin (usually, fish feed and dwell at coral reef are more likely to contain ciguatoxin) most common in grouper, snapper, barracuda, kahala, and moray eel
  • eat fewer coral reef fish
  • eat small amount of coral reef fish at any one meal
  • avoid eating the roe, liver, guts, head and skin of coral reef fish
  • avoid consuming alcoholic beverages and nut or seed products when eating coral reef fish or when suffering from ciguatera fish poisoning
  • buy coral reef fish from reputable and licensed seafood shops and those caught from safe harvesting area
Scombroid Fish Poisoning Histamine a few minutes to an hour after consuming the affected fish metallic, sharp or peppery taste, intense headache, dizziness, nausea, vomiting, facial swelling and flushing, burning throat and diarrhoea fish containing histamine, deteriorated fish because of failed temperature control at some point between capture and consumption most common in the member of Scombroidea family (tunas and mackerels)
  • buy fish from reputable and licensed seafood shops
  • proper handling of fish, including rapid chilling of fish after death, maintenance of low temperature during storage and where possible during processing
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