Table. Clinical Syndromes Associated With Foodborne Diseases Clinical Syndrome Incubation Period Causative Agents Commonly Associated Vehiclesa Nausea and vomiting 2–4 h Staphylococcus aureus (preformed enterotoxins, A through V but excluding F) Food contaminated by infected food handler that is not cooked or is improperly cooked and stored, including ham, poultry, beef, cream-filled pastries, potato and egg salads, mushrooms, unpasteurized cheese 1–6 h Preformed Bacillus cereus (emetic toxin cereulide) Contaminated food that is improperly stored after cooking, including rice 1 h Heavy metals (copper, tin, cadmium, iron, zinc) Acidic beverages, metallic container 1 h Vomitoxin (deoxynivalenol) Foods made from grains such as wheat, corn, barley 1–3 days Rotavirus Food contaminated by infected food handler 3–4 days Astrovirus Bivalve mollusks grown in polluted waters, fresh produce (greens, berries) irrigated with contami- nated water, food contaminated by infected food handler that is not cooked or is improperly cooked and stored (ready-to-eat salads/sandwiches) Varies Listeria monocytogenes Soft cheeses, raw milk, hot dogs, cole slaw, ready-to eat delicatessen meats, produce (eg, sprouts, cantaloupe) Flushing, dizziness, burning of mouth and throat, palpitations, headache, gastrointestinal tract symptoms, urticaria 1 h Histamine (scombroid) Fish (bluefish, bonita, mackerel, mahi-mahi, marlin, tuna, skipjack, and many other fish types) APPENDIX VII CLINICAL SYNDROMES A SSOCIATED WITH FOODB ORNE DISEASES 1087
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