An estimated 48 million cases of food poisoning occur annually in the United States that result in approximately 128,000 hospitalizations and 3,000 deaths.1 Foodborne illness can be caused by bacteria and viruses, parasites, mold, toxins, and contaminants, as well as allergens.2 Food poisoning can also be caused by toxic substances that naturally exist in food (eg, mushrooms), chemical toxins (eg, pesticides, melamine), and molds.

According to the Centers for Disease Control and Prevention, the top five pathogens that cause foodborne illnesses in the United States are Norovirus (58%), Salmonella, non-typhoidal (11%), Clostridium perfringens (10%), Campylobacter spp. (9%) and Staphylococcus aureus (3%).3 While most cases of food poisoning are self-limiting, serious long-term consequences are associated with certain pathogens. The table below summarizes food sources most commonly contaminated with the top 5 illness causing pathogens, the signs & symptoms, and the recommended treatment and management of foodborne illness.

Table 1.

Microorganism Food Sources Onset After Ingestion Signs & Symptoms Management
  • Raw produce
  • Contaminated drinking water
  • Uncooked foods and cooked foods that are not reheated after contact with an infected food handler
  • Shellfish from contaminated waters
12–48 hours
  • Nausea
  • Vomiting (more prevalent in children)
  • Abdominal cramps
  • Diarrhea (more prevalent in adults)
  • Fever
  • Headache
  • Usually resolves in 12–60 hours
  • Ensure adequate hydration
  • Maintain balanced diet
  • Avoid alcohol
Salmonella (nontyphoidal)
  • Eggs
  • Poultry
  • Meat
  • Unpateurized dairy products or juice
  • Cheese
  • Contaminated raw produce
6–48 hours
  • Diarrhea
  • Fever
  • Abdominal cramps
  • Vomiting
  • Usually resolves in 1-2 days
  • Rehydration with oral or IV fluids
  • Severe cases require antibiotics: third generation cephalosporins, fluoroquinolones or ampicillin (subject to susceptibility)
Clostridium perfringens
  • Meats
  • Poultry
  • Gravy
  • Dried or precooked foods
  • Food in institutional settings, where food is prepared several hours before serving
8–16 hours
  • Intense abdominal cramps
  • Watery diarrhea
  • Usually resolves in 24 hours
  • Oral rehydration
  • Severe cases may need IV fluids and electrolytes
  • Antibiotics are not recommended
Campylobacter spp. (80% by Campylobacter jejuni)
  • Raw or undercooked poultry and meat
  • Unpasteurized milk
  • Contaminated water
2–5 days
  • Diarrhea (may be bloody)
  • Cramps
  • Fever
  • Vomiting
  • Usually resolves in 2–10 days
  • Ensure adequate hydration
  • Severe symptoms may require antibiotics treatment such as macrolides or fluoroquinolones
Staphylococcus aureus
  • Food or water contaminated from environmental surface contact or respiratory droplets
1–6 hours
  • Sudden onset of severe nausea and vomiting
  • Abdominal cramps
  • Diarrhea and fever may be present
  • Usually resolves in 1-2 days
  • Rest and rehydration are recommended treatment
  • Avoid antibiotics because it does not affect staphylococcal toxin