Foodborne illness is typically short-lived and primarily involves gastrointestinal symptoms. However, certain pathogens cause more life-threatening disease and certain individuals — because of age or immune status — are more likely to experience severe symptoms. More serious effects are often associated with specific pathogens: Clostridium botulinum is often lethal; E. coli O157.H7 has become infamous for causing hemolytic uremic syndrome in children; Listeria can cause miscarriages and toxoplasmosis is an important cause of congenital malformations; septicemia may result from infections with Salmonella and Listeria. Foodborne bacteria have also been shown to cause chronic effects (sequelae), including arthritis, ankylosing spondylitis, renal disease, cardiac and neurological disorders, and nutritional and malabsorptive disorders. Some data indicate that 2–3 % of the population as a whole develop chronic effects after foodborne illness, but follow-up of some outbreaks of salmonellosis revealed that 15–16 % of cases suffered reactive arthritis in the months following their initial illness (19,20). Persons positive for the major histocompatibility class antigen B27 have a significantly greater relative risk for developing some reactive diseases. As many as 20 % of exposed, genetically susceptible persons may suffer these complications. It can be difficult to identify specific foodborne pathogens as the causes of chronic illnesses because effects sometimes occur after a mild illness and may not be manifested until days or weeks after gastrointestinal symptoms hav
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