Many of us have suffered from what we believed may have been a foodborne illness,
and have suffered at home without seeking clinical care because we knew it was likely
to be over in a day or so. However, foodborne illness may present under unusual circumstances,
as I know from having been a victim of a multi-state outbreak of Salmonella
serotype Agona present in a toasted oat cereal in May of 1998 (JAMA 280
(5):411). This was the first known case of Salmonella contamination of a breakfast
cereal; although, Salmonella serotype Senftenberg contamination of an infant cereal
has been reported in the United Kingdom.
In case of contaminated breakfast cereal, exposure may occur daily or intermittently
for several days. By the time I sought clinical advice from a gastroenterologist I felt
fine, and after a battery of tests he said, “I wish all of my patients were as healthy as
you.” It wasn’t until I heard a report on CNN later that summer that I realized what had
happened. My mother, who shops at the outlet store in Indiana that carried the brand in
question, had brought a box of the oat cereal to me during a visit to Tennessee. The box
was from the contaminated lot, so it is likely that one undiagnosed clinical case from
Tennessee can be added to the MMWR 1998; 47:462-464 report.
This case exemplifies several of the problems that plague food processing, preparation
and inter- and intra- country shipping and importation. Exposure and clinical
symptoms may differ in ways that neither patients nor clinicians suspect a foodborne
pathogen. All of these factors lead to the under reporting of foodborne illnesses.
Today people expect a safe food supply and to meet these goals global cooperation
in food pathogen research, monitoring and education are necessary. Foodborne
Diseases covers several significant foodborne bacterial pathogens, viral infections, toxins
and pathogen control strategies in an effort to educate and reduce the risk of
foodborne infections in this millennium.