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Foodborne diseases remain a major cause of morbidity and mortality in the general population, particularly in vulnerable groups. These diseases emanate from either the toxin of the “disease-causing” microbe, or by the human body’s reactions to the microbe. More than 250 different types of viruses, bacteria, parasites, toxins, metals, and prions are associated with foodborne diseases in humans, which are mostly manifested as acute gastroenteritis that could be self-limiting. Most commonly, the outbreaks take place due to the ingestion of pathogenic bacteria like Salmonella Typhi, Escherichia coli, Staphylococcus aureus, Vibrio cholera, Campylobacter jejuni, and Listeria monocytogenes. The disease usually happens as a result of toxin secretion of the microorganisms in the intestinal tract of the infected person. Usually, the level of hygiene in the food premises reflect the quality of the food item, hence restaurant or stall with poor sanitary condition is said to be the contributor to food poisoning outbreak.



1.0     Introduction   

Foodborne illnesses encompass a wide array of illnesses caused by ingestion of foodstuffs contaminated with microorganisms or chemicals. Contamination usually occurs during food preparation or serving; and it is a growing public health problem in developed countries (USA, Australia) and they remain an important cause of morbidity and mortality, posing a major public health challenge globally. They contribute to mark economic loss, reduction in quality of life and productivity.

It is difficult to determine the exact mortality associated with foodborne illnesses (Helms et al., 2003). WHO estimates that, worldwide food borne and water borne diarrheal diseases have killed about 2.2 million people annually and 1.9 million of them are children (WHO, 2004). The global incidence of food borne disease is difficult to estimate, but it has been reported that in 2005 alone 1.8 million people died from diarrheal diseases. A great proportion of these cases can be attributed to contamination of food and drinking water (WHO, 2007). In Australia, there are an estimated 5.4 million cases of food borne illness every year, causing 18,000 hospitalizations, 120 deaths. In France, every year 113,000 people were hospitalized causing 460 deaths. An estimated 11 million people suffer food-related illness every year in Canada. In 2005, there were 1545 incidents of food poisoning in Japan, in which 27,019 people were affected with seven deaths reported. In 1994, an outbreak of salmonellosis due to contaminated ice cream occurred in USA, affecting an estimated 224,000 people. In 1988, an outbreak of hepatitis A, resulting from the consumption of contaminated clams, affected some 300,000 individuals in China (WHO, 2007).

      According to the World Health Organization, death of about two million individuals in the world is due to food borne diarrheal diseases. The economic impact of food-borne diseases is also substantial. In the US, the estimated costs for these diseases may reach $35 billion annually. There are a number of factors involved in the emergence or re-emergence of pathogens associated with food borne illness. These include environmentally-related factors, such as climate change, deforestation, food-related factors such as changes in food production and distribution practices, consumer-related factors such as increased international travel and changes in eating habits, and pathogen-related factors such as genetic changes in microorganisms as a result of exposure to environmental stresses. One major factor is the increased globalization of the food supply, resulting in transfer of pathogenic agents between countries. The use of antimicrobials for prophylaxis in animals has contributed to the emergence of bacterial strains resistant to multiple antibiotics

          Food handlers are the most common source of contamination because they can spread harmful organisms by means of fecal-oral route or skin lesions, as well as unclean kitchen utensils or kitchen counters (Linscott, 2011). In general, the frequent sources of foodborne outbreaks are meat, dairy products, eggs and vegetables whereas the common agents of foodborne outbreaks are Salmonella Typhi, Staphylococcus aureus, Escherichia coli and Clostridium perfringens (Pires et al., 2012). The correct food handling practices in every step of food preparation is essential to avoid contamination from the environments. Ready to eat or prepared food has become a necessity due to fast pace of living nowadays. The limitation of time for most people to prepare meals for themselves has increased the demand for food consumption from various food service establishments and it has also becoming a trend for most of Malaysian to eat out (Ali and Abdullah, 2012). However, some food premises neglect the importance of hygiene and sanitation and thus, increase the risk of foodborne illness among the consumers. Food handlers are also the main food contamination vehicles (Campos et al., 2009), and their level of practice in the kitchen plays an important aspect on the distribution of harmful microorganism from the environment to the food items. Sometimes consumers give prioritization on the low price of the food that they purchased instead of the hygiene level of the food premises. . 

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