Milk Borne Diseases-II

Mansur-ud-Din Ahmad
 Outline
 E. coli
 Vibrio cholerae
 Fungal intoxications
 Milk-borne toxi-infections
 Clostridium perfringens and B. cereus
 Uncertain organism
 Emerging pathogens (Listeria,
Campylobacter, Yersinia
 E. coli poisoning
 Enteritis in infants
 Travellers’ diarrhoea & food

poisoning in adults
 By invasion or by enterotoxins,

heat labile (LT) & heat stable (ST)

 Cont…
 Contaminated Milk & milk products (ice-cream,
kulfi, dried milks, cheese) with toxigenic strains of
E. coli
 Minimum of 10 5- 10 7 cells/g produce
 LT-inactivated at 65°C for 30 min
 ST- resist that temp.
 LT & ST toxins-cause food poisoning
 Children more susceptible
 Sensitive adults
 Sources
 Water supplies contaminated with faecal
matter
 Unhygienic practices by the handlers
 Infected animals excrete organisms
 Cont…
 Symptoms- resemble those of cholera
 Massive watery diarrhoea

 ST type-diarrhoea, with or without

vomition, Fever in children but not in

adults
 Incubation period-8-24 h
 Prevention and control
 The faecal contamination of water
supply should be avoided.
• Handlers follow hygienic practices.
• Cross contamination from infected
animals should also be avoided.
 Cholera (Vibrio cholerae)
 Massive epidemics-unhygienic practices
 Mainly a water-borne illness, contaminated
milk and milk products may also transmit
 Adheres to the epithelial cells lining the
crypts of mucosa in the small intestine-
produces enterotoxin-causes loss of fluid
and electrolytes from the body-dehydration
 Sources
i) Milk may be infected by soiled hands of a
patient or a convalescent carrier.
ii) Use of infected water for dairy purposes.
iii) Adulteration of milk with contaminated
water may also be one of the causes.
 Symptoms
Mild cases-diarrhoea
Severe cases-diarrhoea, vomiting, rice water
stools, abdominal pain, thirst, dehydration
Short course terminating in death, sometimes
within 12 h
 Cont…
Incubation period-3 days (few hours-5 days)
Diagnosis V. cholerae isolated from faeces
(infected individuals and carriers)
Intraperitoneal inoculation of culture in
guinea pigs cause death within 24 hours.
Susceptibility and immunity-resistance varies
Clinical attacks confer temporary
immunity.
Active immunity for 6-12 months (vaccines)
 Prevention and control
 Pasteurization of milk and milk products.
• Sanitary disposal of human excreta.
• Protection of water by boiling.
• Sanitary preparation and handling of
products.
• Control or destruction of house flies.
 Cont…
vi) Education of public in personal cleanliness.
vii) Isolation of patients.
viii) Disinfection of stools and vomits, soiled articles
ix) Food left by patients should be burnt.
x) Room of patient thoroughly cleaned and disinfected
xi) Carriers should be isolated.
xii) Use of cholera vaccine in exposed population
groups.
 Fungal intoxications
Aspergillus, other molds Penicillium,
Fusarium etc.
a) Aflatoxicosis-common A. flavus & A.
parasiticus
b) Preformed toxin secreted in milk by
the milch animal fed with aflatoxin
containing feeds.
 Cont…
Ingested Aspergillus-toxins are metabolised
and secreted in milk (M1 & M2)
B1, B2, B2a aflatoxin B1 is the most abundant
and most toxic of the aflatoxins
G1, G2 and G2a.
 Cont…
 Mycotoxins are heat stable, potent, strong
toxicity (highly carcinogenic)
 Raw milk, ice-cream powder, evaporated
milk, dried milks and cheese
 Permissible limit 90 ppm.
 Sources are aerial contamination, Soil &
contaminated foods, Poor storage
conditions
 Acute aflatoxicosis
 Symptoms-liver hyperplasia, tissue
haemorrhage, anorexia, hepatitis and
finally death
 Prevent contamination of milk and milk
products as well as feed
 Proper storage and fungistatic agents
 Detoxification of aflatoxins by physical,
chemical or biological agents (relatively
impractical)
 Milk-borne toxi-infections
 Clostridium perfringens & B. cereus
 By ingestion of contaminated milk or milk
products
 Canned products favorable for toxi-
infection by Clostridium
 Five distinct types of Clostridial toxins, A,
B, C, D, and E. Two of the enterotoxins are
lethal and emetic.
 Sources of organism
 Commonly found in soil and faeces
 Water supplies contaminated with sewage
 Disease in human
Gastroenteritis-due to the production of
exotoxin/enterotoxins resistant to intestinal
juices
Children more susceptible lethal dose 2,000
mice/mg
Symptoms. Diarrhoea, vomiting, nausea,
abdominal pain
 Cont…
Incubation period- 8-22 h, not very fatal
Prevention and control
i) Proper heat treatment of milk.
ii) Milk should not be stored under conditions
suitable for the spores to vegetate
iii) Rapid cooling after pasteurization and
storage below 15°C
iv) Environment hygiene should be observed.
 Bacillus cereus poisoning
Present in all raw milk & pasteurized milk,
cream, cakes, pastry, processed cheese etc.
Sources
i) B. cereus from mastitis animals
ii) Animal’s teat, skin, milking cans
iii) Soil
 Toxins
Three types of toxins
 Haemolysin
• Lecithinase (phospholipase C)
• Enterotoxin
Enterotoxin responsible for food poisoning
Lecithinase and haemolysin play role in the
pathogenesis
 Types of poisoning
Two types
diarrhoeal type
vomiting type
Symptoms-are nausea, diarrhoea,
abdominal pain
Incubation period-one day or less (6-12 h)
 Prevention and control
i) Prompt cooling of milk/milk products
ii) Environment hygiene be maintained aerial
contamination should be avoided.
iii) General hygiene conditions should be
maintained during production and marketing
 Uncertain pathogenesis
Proteus infection: Proteus vulagris rarely
Proteus mirabilis may cause summer
diarrhoea
Organism easily destroyed by heat-proper
pasteurization, proper sanitizing
 Aeromonas infection
Associated with animals that live in water.
Aeromonas hydrophilia -enterotoxigenic,
exact role in food poisoning through milk
and milk products is not known
• Appropriate hygienic practices during
production and processing of milk
 Citrobacter infection
Rarely associated with gastroenteritis through
ingestion of contaminated
A few strains produce enterotoxins
Klebsiella infection- milk-borne illnesses rare
K. pneumoniae produce heat stable and heat
labile toxins-comparable to E. coli.
 Pseudomonas infection
Pseudomonas encountered in milk are Ps.
Putrefaciens, Ps. Fluorescens, Ps. fragi, Ps.
viscosa and Ps. aeruginosa. Of these, Ps.
aeruginosa appears to play an important role
in food poisoning through milk and milk
products
Sources of the causative organism
Water supply is the initial source of this
organism.
i) Improperly cleaned utensils, equipments,
pipelines, milk cans, churns, holding cans,
valves, milking machines, etc. constitute the
other sources.
ii) Udder teats and cowshed environment may
also be the potential sources.
 Cont…
Disease in relation to human beings and animals
Human beings. In human beings, Ps. aeruginosa
can produce urinary tract infections, eye
infections, ear infections, septicaemia, abscess,
meningitis and enteritis. The gastrointestinal
distrubances dur to enterotoxin produced by
Ps. aeruginosa have also been recorded.
 Cont…
Ps. aeruginosa can cause mastitis, necrotizing enteritis,
abortion, vaginitis and endometritus in cattle
Prevention and control
i) Proper heat treatment of milk.
ii) Hygienic conditions during production and processing.
iii) Microbicidal treatment of dairy water supply.
iv) Proper cleaning and sanitization of dairy utensils and
equipments.
 Emerging pathogens
Listeriosis- Listera monocytogenes in
milk & milk products
Increase in number of outbreaks of
listeriosis
L. Monocytogenes cause mastitis
Gram-positive, non-sporulating
rods, grow at 1° to 45°Cproduce
haemolysin (aplha, beta)
 Source of organism
i) Infected animals in milk through infected
udders
ii) Handlers may introduce the organism
iii) Unhygienic practices during production
and processing of milk
iv) Faecal contamination of milk and water
v) Contaminated refrigerators
vi) Survive some of the processing conditions
(ingestion by leucocytes in milk give
protection against heat treatment)
 Listeriosis in man
Listeriosis lethal in man, acute meningitis with
or without septicaemia.
Sudden onset with fever, nausea, headache,
vomiting, followed by delirium, coma,
collapse and shock resulting in death if not
treated promptly and properly.
 Prevention and control
i) Strict hygiene practices should be followed
during production and processing of milk.
ii) The human carriers should not be allowed to
handle milk and milk products.
iii) Culling of the infected animals.
iv) Proper heat treatment of milk.
v) Proper storage conditions.
 Campylobacter jejuni
Relatively new bacterium
Variety of warm-blooded animals infected with
Campylobacter jejuni.
Sources of the causative organism

i) The organism has been isolated from

intestinal tracts and faecal matter of man,
goat, sheep,
ii) Polluted water contaminated with C. jejuni
iii) Infected personnel and animals.
 Diseases in man and animals
C. jejuni common cause of acute gastro-enteritis
Also implicated in mastitis in milch animals
Symptoms. Severe abdominal pain and diarrhea.
 Prevention and control
i) Milk be properly pasteurized and heat
treated.
ii) Water supplies be adequately treated
chlorination
iii) Good hygiene by dairy personnel
iv) Persons suffering not be allowed to handle
milk and milk products
 Yersinia enterocolitica
Yersiniosis-incidences of illness through raw
and pasteurized milk
 Water or streams often contain this organism
 Faecal contamination
 Infected animals
 Contaminated raw materials
 Disease in man
 Acute syndrome with appendicitis
 Y. enterocolitica produces several disease
syndromes in human beings on ingestion of
contaminated milk
 Abdominal pain and fever
 Vomiting and diarrhoea
 Enterotoxin production andinvasiveness of the
organism.
 Prevention and control

i) Avoiding faecal contamination.

ii) Following hygienic practices.
iii) Avoiding handling by infected personnel
 Vibrio parahaemolyticus
Gastro-enteritis in human beings
Symptoms-Diarrhoea & gastroenteritis.
Abdominal cramps, nausea, vomiting,
headache, chills and fever. In severe cases,
death may also occur.
Incubation period. This varies from 12-24 h. The
symptoms persist from few hours to 10 days
with the usual duration of 2-3 days.
 Prevention and control
Contamination of water should be avoided.
Application of good sanitary practices
Personnel hygiene help in preventing the cross-
contamination.
 Other milk-borne diseases
Tuberculosis (TB): Milk-borne tuberculosis
directly or indirectly related to the
consumption of raw milk from infected dairy
herds
Bovine type causes non- pulmonary type TB
Avian type cause both types of tuberculosis
 Cont…
Species Host
M. tuberculosis Man
M. bovis Cattle and man
M. avium Birds and swine; rarely
man